声门型喉癌T_3病变喉部分切除术后疗效评价

Partial laryngectomy for T_3 glottic carcinoma

目的 探讨喉部分切除术对声门型喉癌T3 病变的可行性及修复材料的选择。方法 对 1986年 1月～ 1994年 1月 78例行喉部分切除术的声门型喉癌T3 病变患者的术式及修复方法进行了回顾性分析。结果 患者 3年、5年生存率分别为 88 5 %、75 6 % ,局部复发率 15 4%。应用了梨状窝粘膜 +甲状软骨板外侧软骨膜、会厌软骨瓣及带状肌双肌双蒂瓣 3种方法修复创面 ,均获得了较好的喉功能恢复。结论 喉部分切除术是根治声门型喉癌T3 病变合理、有效的方式 ,但不能完全替代全喉切除术 ,应根据切除范围选择合理的修复方式。

Objective To explore the possibility of partial laryngectomy for T 3 glottic carcinoma and selection of reconstruction methods Methods From January 1986 to January 1994, 78 patients with T 3 glottic carcinomas were treated by partial laryngectomy The operative techniques and the reconstruction methods were retrospectively analyzed Results The overall 3 and 5 years survival rates were 88 5% and 75 6% respectively The local recurrence rate was 15 4% The reconstruction methods for laryngeal defect repariring following partial laryngectomy were the use of pyriform sinus mucosa with thyroid perichondrium, epiglottic cartilage and bi pedicaled and bi muscular flap of strap muscle The function of respiration, phonation and deglutition recovered well Conclusion The partial laryngectomy is suitable for T 3 glottic carcinoma The selection of reconstruction method is based on the size of laryngeal defect