环状软骨上喉部分切除术治疗中晚期喉癌的效果

Supracricoid partial laryngectomy for laryngeal cancer

目的:探讨环状软骨上喉部分切除术治疗中晚期喉癌的临床效果。方法:18例声门型癌和5例声门上型癌,包括:T1bN0M03例,T2N0M06例,T3N0M012例,T4N0M02例,分别行环状软骨上喉部分切除术加环舌固定术或环舌会厌固定术进行治疗。结果:3年生存率92.9%(13/14)。术后第10～18天(平均16天)拔气管套管,拔管率100%。术后拔除鼻饲管时间为第7～35天(平均14天)。23例患者均能进行日常言语交流。结论:环状软骨上喉部分切除术加环会厌固定术或环舌会厌固定术可以治疗T1b～T4声门型和声门上型喉癌。该技术在根治肿瘤的同时能使患者保留呼吸、吞咽和部分发音功能,值得推广。

Objective：To discuss some surgical techniques of supracricoid partial laryngectomy for middle-late stage laryngeal cancer.Methods：From January 2002 to December 2004,our department successfully had employed supracricoid partial laryngectomy（SCPL）with cricohyoidoepiglottopexy（CHEP）or cricohyoidopexy（CHP）for 23 cases of laryngeal carcers,including 18 glottic cancers and 5 supraglottic cancers,3 of them classified as T1b N0 M0,6 of them as T2 N0 M0,12 of them as T3 N0 M0,2 of them as T4 N0 M0.Results：Overall survival rate was 92.9%.The time of decannulation was from 10 days to18 days（mean 16 days）,and the decannulated rate was 100%.The time of removing feeding tube was from 7 days to 35 days（mean 14 days）,all 23 patients could communicate with their artificial voice.Conclusion：SCPL＋CHEP/CHP can treat T1b^T4 glottic and supraglottic laryngeal cancers.This surgical technique can preserve the laryngeal functions of respiration,swallowing,partial speech as well as resect the laryngeal tumor radically.