前联合上喉室入路在声门上型喉癌中的应用

Supraglottic horizontal laryngectomy via the supra-anterior commissure approach

目的探讨前联合上喉室入路行喉声门上水平部分切除的适应证。方法8例选择性喉鳞状细胞癌巨大外生型声门上型T2～3N0-2c患者，无声带固定，无环后区受侵，行前联合上喉室入路切除原发病灶及水平半喉，常规修复。结果所有患者无切缘阳性，术后发音好，无咽瘘发生，进食时间8—26d，随访存活2年以上5例。结论对于喉癌声门上巨大外生型，无喉室及声带受侵的患者，前联合上喉室入路是比较好的选择，符合肿瘤切除原则。

Objective To evaluate the indications for supraglottic horizontal laryngectomy via the supra-anterior commissure approach. Methods Eight patients with large exophytic supraglottic squamous cell carcinomas were selected and treated with supraglottic horizontal laryngectomy via supra-anterior commissure approach. Clinical stages of these patients were T2-3N0-2c Withont vocal cord involvement and postcricoid invasion. Results All patients were operated successfully and adequate surgical margins were achieved. Satisfactory laryngeal function was reserved and no pharyngeal fistula occurred in any patient. The duration for oral intake ranged from 8 to 26 days. Five patients were alive in the 2 year follow-up. Conclusion For large the exophytic supraglottic laryngeal cancer, without ventricle and vocal cord invasion, the supra-anterior commissure approach is a good method and the principles of tumor resection can be observed.