声门癌功能性手术探新

New Function-Conservation Therapy for Glottic Carcinoma

1983年开始,对声门型喉癌采用喉裂开术保留甲状软骨板的喉肿瘤局部切除,用颈阔肌筋膜修复喉缺损,术后进行放疗,共治疗44例病人。随访5年以上者30例,男28例,女2例。T_123例,T_26例,T_31例。1例术后1年肿瘤局部复发,做全喉切除至今无复发。本组病例5年生存率为96.7％。气管套管拔除率为100％。术后除部分患者有轻度声嘶外,发音、保护、呼吸功能均正常。术后放疗量为40～60GY,无1例出现严重放疗反应。本手术方法简单,保留喉功能,手术时间短,患者术后恢复快,是治疗声门癌的有效方法。

Since 1983,laryngofissure was performed on patients with glottic carcinoma. During the operation, all malignant tissues were removed. Meanwhile the thyroid cartilage was preserved and the defective part was reconstructed with pedicled platysma fascia. Radiotherapy was performed on postoperative patients. Thirty cases(28 male,2 female)had been followed up for 5 years. One case had recurrence of carcinoma 1 year no after operation,and the others had no signs of relapse up to now after total laryngectomy. The 5 year survival rate was 96. 7%. The decannulation rate was 100%. Despite several cases of slight hoarseness, the postoperative preservation of function, respiration and phonation were normal. Under the 45-50 GY dose of postoperative radiotherapy side effects had been found. This operation could not only remove the malignant tissues but also preserve the normal function of the larynx. So it is a useful and reliable technique for patients with glottic carcinoma.