声门上水平垂直半喉切除术

Supraglottic Horlzontal-vertical Hemilaryngectomy

１９８０～１９８９年４１例喉鳞状细胞癌行声门上水平垂直半喉切除术，其中男性占８７．８％，５０～５９岁占７８％。Ｔ＿３，４占７０．７％，Ｎ＿１￣３占４３９％。３年和５年生存率分别为８２．９％和７５．７％。４１例术后均获不同程度发音和会话能力气管套管拔除率为８５．４％。４１例经进食训练，最后均恢复吞咽功能。介绍了手术步骤、要点，并对原发癌术后复发、颈淋巴结处理、预防术后误吸在术中采取的改进措施和提高气管套管拔除率等问题进行了讨论。

During the years 1 980 to 1 989,4 1 patients(36 men and 5 women)with squamous cell carcinoma of larynx had undergone the supraglottic horizontal-vertical hemilaryngectomy.The patients'age ranged from 43 to 67 years;78% was aged from 50 to 59.Among 41 patients 23 were at the Depart-ment of Head and Neck Surgery of Shanxi Tumor Hospital and the other 18 patients at the Department of ENT of Beijing Hospital.There were 70.7% (29 patients) in T3 and T4 and 43.9%(18 patients)in N_1￣3.The 3-and 5-year survival rates of the patients were 82.9% and 75.7% respectively.The 41 pa-tients have acquired the function of speech and swallowing in different degree;854%(35 patients)was extubated.In this article,the main procedure of the operation is described and the modified method dur-ing the operation dealing with the recurrence of the original careinoma,the lymph node metastasis,aspi- ration of the food and raise the raising of of extubation.