复发性喉癌的外科挽救治疗

Salvage surgery for recurrent laryngocarcinoma

目的:探讨喉癌复发患者采用手术治疗的疗效及预后。方法:采用挽救性手术治疗43例复发喉癌患者。采用Kaplan-Meier法计算生存率,Log-rank检验单因素分析临床因素对预后的影响。结果:挽救术后并发症为23.3%(10/43),其中感染及咽瘘发生率18.6%(8/43)。挽救手术后随访满3年有32例患者,3年生存率为56.3%,满5年有25例患者,5年生存率为32.0%,首诊分期与3年生存率相关(P<0.05)。喉内复发组及喉功能保留组预后较好,但差异无统计学意义。结论:挽救性手术是复发性喉癌较好的治疗方法,其预后与首诊分期相关,对局部复发的喉癌患者选择性保留喉功能可获得较好的疗效及预后。

Objective：To study the curative effect and prognosis of salvage surgery performed for recurrent laryngocarcinoma.Method：The clinical data of 43patients with salvage surgery for recurrent laryngocarcinoma hospitalized in Nanfang Hospital between 2003and 2011were analyzed retrospectively.Survival analysis was performed by using Kaplan-Meier method and prognosis factors were analyzed by Log-rank test.Result：After salvage surgery,10（23.3%）patients developed postoperative complications.Pharyngocutaneous fistula and infection occurred in 8（18.6%）patients.Kaplan-Meier analysis showed that patients survived for 3-year（n=32）and 5-year（n=25）after salvage surgery were 56.3% and 32.0% respectively.Univariate analysis indicated that clinical stage in the first diagnosis was significantly correlated with 3year overall survival（P〈0.05）.Local recurrence of laryngeal cavity group and preservation of laryngeal function group had a good prognosis respectively,but no significant difference between them.Conclusion：Salvage surgery is a good choice for recurrent laryngeal carcinoma. Outcomes of these patients were correlated with clinical stages.Laryngeal function preserving surgery for local recurrent laryngeal carcinoma can achieve a expected curative effect and prognosis.