喉癌的手术治疗(129例报告)

Surgical Treatment of Laryngeal Cancer(Report of 129 Cases)

目的 探讨提高喉癌患者术后生活质量及生存率。 方法 回顾分析 1985～ 1996年 12 9例喉癌患者的手术及预后。手术方法为全喉切除 5 0例、水平垂直 (3/ 4)喉部分切除 10例、声门上喉部分切除 8例、额侧喉部分切除 3例、垂直部分喉切除术 5 0例和声带切除 8例。 结果 喉部分切除全部病例术后恢复发音功能 ,2～ 3周拔除鼻饲管 ,6 7例拔除气管套管 ,12例不能拔管。喉部分切除 3年及 5年生存率分别为 82 .3% ,70 .8% ,全喉切除 3年及 5年生存率分别为 86 .0 % ,72 .0 %。 结论 喉部分切除术是保留喉功能的根治性手术。喉癌患者经严格掌握适应证 ,正确选择术式 。

Objective\ To improve life quality and survival rate for patients of laryngeal carcinoma after operation.\ Methods\ 129 cases with laryngeal cancer from 1985 to 1996 were summarized.\ According to UICC in 1992, 23 cases were supraglottic carcinoma(T\-1 3 cases, T\-2 13 cases, T\-3 2 cases, T\-4 5 cases), 96 cases glottic carcinoma(T\-1 40 cases, T\-2 11 cases, T\-3 5 cases, T\-4 40 cases), 5 cases infraglottic carcinoma(T\-4 5 cases), and 5 cases transglottic carcinoma(T\-2 4 cases, T\-3 1 case).\ In common 6 kinds of operations were performed: total laryngectomy 50 cases, among them 10 cases underwent concurrent neck dissection(8 unilateral, 2 bilateral), horizontal vertical(3/4) laryngectomy 10 cases(3 unilateral concurrent neck dissection), supraglottic laryngectomy 8 cases, frontolateral laryngectomy 3 cases, vertical laryngectomy 50 cases, and cordectomy 8 cases.\ Results\ All cases of partial laryngectomy restored their phonation and overcame aspiration when removing nasal feeding tube 2~3 weeks after operation, in which 67 cases were decannulated 1~3 months after operation.\ 12 cases could not be decannulated.\ The three and five survival rates were 80.3%, 70.8%, in partial laryngectomy.\ The 3\|year and 5\|year survival rate were 86.0%, 72.0%, in total laryngectomy.\ Conclusion\ Partial laryngectomy is a kind of selected radical operation with reservation of laryngeal function.\;