全喉切除一期粘膜瓣法气管食管发音重建术

Voice reconstruction in patients with total laryngectomy by mucosal flap tracheal esophagus shunt: Report of 48 cases

对４８例中、晚期喉癌患者行全喉切除一期粘膜瓣法气管食管发音重建术，４４例（占９１．２５％）恢复其语言功能，避免了误咽，４例不能发音。方法：于气管上端后壁、食管前壁分别切取长约２０～２５ｍｍ或稍长“Ｕ“形粘膜瓣，对边缝合形成其上端宽约１５ｍｍ为蒂部，下端宽约１０ｍｍ，于基底下横形瘘口纳入食管，形成类似“会厌”粘膜活瓣遮盖瘘口。术后无一例发生误咽，８～１０天即可练习发音，语言清晰连贯，语言强度３８例近似术前水平。本术式对除肿瘤向下侵入气管外的中、晚期喉癌患者。

Abstract The clinical results of voice reconstruction by mucosal flap for tracheal esophagus shunt in 48 patients with total laryngectomy were reported.There were 46 males and 2 females.The mean age was 59.The clinical stages of these 48 patients with laryngeal carcinoma were as follows:T 3N 0M 0 for 16 cases,T 3N 1M 0 for 12 cases,T 3N 2M 0 for 2 cases,T 4N 0M 0 in 10 cases,T 4N 1M 0 in 7 cases and T 4N 3M 0 in 1 case.All patients were followed up from 6 months to 6 years after surgery.Results showed that voice reconstruction in 44 cases (91 3%) was successful and failed in 4 cases.The technique of tracheal esophagus shunt and its indications were discussed.