声门上水平部分喉切除术

Supraglottic horizontal partial laryngectomy

目的为提高喉癌患者的生存率和生存质量。方法对传统的声门上水平部分喉切除术式进行了一定的改进和探索：将双侧甲状软骨外膜内翻覆盖同侧喉内创面，将其切缘与声带、喉室面粘膜缝合，咽粘膜原位间断缝合，折叠缝合双侧带状肌充做咽喉腔前壁而关闭咽喉腔。回顾分析了我科１９８３～１９９３年９２例声门上水平部分喉切除术，其中男８０例，女１２例，男女之比为６．７∶１。５０～５９岁居多，占７２％（６６／９２）。Ⅲ、Ⅳ期占７８．３％（７２／９２），全部经病理证实为鳞状细胞癌。结果３年、５年生存率分别为７５％和７２％。术后发音功能良好，气管套管拔除率８４．８％，吞咽功能７６例在２～４周内恢复。结论该术式是一种较好的治疗部分喉癌患者的手术方法。

Objective To evaluate the supraglottic horizontal partial laryngectomy in the treatment of laryngeal cancers. Methods Some researches and modifications are performed on the standard supraglottic horzontal partial laryngectomy: the wounded area in the laryngeal cavity is covered with the lateral membrane of thyroid cartilage; the laryngeal cavity is closed as its anterior wall by folding and sewing up the sternohyoid muscles. From 1983 to 1993,92 patients(80 men and 12 wowen) with quamous cell carcinoma of larynx were treated with supraglottic horizontal partial laryngectomy. The patients age ranged from 39 to 72 years;72% aged from 50 to 59.There were 72 cases (78.3%) in the stages Ⅲ andⅣ. Results The 3 and 5 year survival rates of the patients were 75% and 72% respectively.Most cases have acquired good speech and swallow function with 2 4 weeks;84.8% (78 patients) were extubated. Conclusion The authors believed that partial laryngectomy was safe and beneficial to some patients with laryngeal cancers.