环上喉切除喉功能重建术78例疗效分析

Retrospective analysis of supracricoid partial laryngectomy with epiglottis preserved and reconstruction of laryngeal function

目的 回顾 2 0年来对喉声门癌保留会厌的环上喉切除喉功能重建的远期疗效 ,研究这一手术的可行性和保证患者生活质量的效果。方法 随访 1980年 1月～ 1996年 1月期间行环上喉切除保留会厌喉功能重建术 78例 ,总结统计其手术疗效。结果 78例患者中 ,随访 3年时有 6 8例存活 ,2例死于肿瘤复发 ,8例死于其它疾病 ,3年生存率 87.2 %。随访 5年有 5 9例存活 ,5年生存率75 .6 % (5 9/ 78)。随访满 10年的 38例患者中有 8例存活 ,占 2 1.1%。存活满 2 0年者 2例。术后拔管率提高到 97.4% (76 / 78)。患者恢复了正常吞咽功能 ,且喉的发音功能理想。结论 改良的保留会厌环上喉切除环咽吻合喉功能重建术既能彻底切除肿瘤 ,又重建喉功能 ,提高了患者的生存质量 。

Objective To retrospectively evaluate the curative and functional consequences of supracricoid partial laryngectomy with epiglottis preserved. Methods From 1980 to 1996, 78 patients underwent supracricoid partial laryngectomy with the epiglottis preserved. The survival rate and the functional results were analyzed. Results Overall three year survival rate was 87.2%(68/78), overall five year survival rate was 75.6%(59/78), and ten year survival rate was 21.1%(8/38). All patients resumed normal oral feeding. 97.4%(76/78) achieved tracheal extubation. Respiratory and speaking functions were good. Conclusion Supracricoid partial laryngectomy with epiglottis preserved and reconstruction of laryngeal function not only improved local cancer control, but also preserves laryngeal physiologic function.