改良咽前径路水平喉部分切除术治疗喉癌下咽癌

Horizontal partial laryngectomy via modified anterior pharynx approach in patients with laryngeal and hypopharyngeal carcinoma

目的探讨改良咽前径路水平喉部分切除术的意义。方法回顾性分析行改良咽前径路水平喉部分切除术患者47例的临床资料。其中,声门上型喉癌35例,下咽上型癌7例,梨状窝内侧壁癌5例。结果47例患者于术后10-40d全部拔出气管套管,患者呼吸通畅,发音良好。1年生存率93.3%,3年生存率71.0%,5年生存率12.8%。术后发生咽瘘3例,其中1例因不能耐受误吸,于术后6月切除残喉。结论改良咽前径路水平喉部分切除术损伤相对较小,功能恢复快,在不影响生存率的基础上,能提高患者的生存质量。

Objective To investigate the clinical value of horizontal partial laryngectomy via modified anterior pharynx approach in the patients with laryngeal and hypopharyngeal carcinoma.Methods Data of 47 cases underwent horizontal partial laryngectomy via modified anterior pharynx approach were retrospectively analyzed,of whom 35 cases were supraglottic laryngeal carcinoma,7cases the upper type of hypopharyngeal carcinoma,and 5 cases the pyriform fossa type of hypopharyngeal carcinoma.Results The tracheal tubes were pulled out within 10 to 40days with unrestricted breathing and good voice.The 1-year survival rate was 93.3%,the 3-year survival rate was 71.0% and 5-year survival rate was 12.8%.Pharyngeal fistula occurred in 3cases,of whom one case received total laryngectomy in 6 months after operation for intolerable aspiration.Conclusion The horizontal partial laryngectomy via modified anterior pharynx approach in the patients with laryngeal and hypopharyngeal carcinoma is a better selection with mild trauma,rapid recovery and improved life quality without reducing survival rate.