经声门旁间隙入路切除声门型喉癌疗效分析

Analysis of curative effect of glottic laryngeal carcinoma excised by paraglottic space approach

目的探讨经声门旁间隙入路声门型喉癌切除术的适应证及疗效。方法回顾性分析2010年1月~2015年3月肇庆市第一人民医院20例确诊为声门型喉癌患者的临床资料,均采用经声门旁间隙入路切除的手术方式,观察患者术后并发症、呼吸、吞咽、发音功能、复发及生存率。结果气管套管拔管率90.0%(18/20);误咽率15.0%(3/20),均通过吞咽训练恢复经口饮食;术后患者存在不同程度声嘶,但可对话交流;肿瘤复发2例,其中l例为喉内复发,1例为颈淋巴转移复发,复发率为10.0%(2/20)。3年、5年累积生存率分别为85.0%(17/20)、80%.0(16/20)。结论经声门旁间隙入路的手术方式适用于部分同时累及声门及声门上区的喉癌,肿瘤暴露清晰、切除彻底,可有效保留喉功能,是理想的手术方式。

Objective To explore the indication and curative effect of resection of glottic carcinoma through the paraglottic space.Methods The clinical data of 20 patients with glottic carcinoma diagnosed in Zhaoqing first people's hospital from January 2010 to March 2015 were analyzed retrospectively.All patients were operated through paraglottic space approach,and we observed their postoperative complications,respiration,swallowing,voice function,recurrence and survival rate.Result The extubation rate of tracheal cannula was 90.0%(18/20),the false swallowing rate was 15.0%(3/20),and the oral diet was restored through swallowing training.The patients had different degree of hoarseness,but they could communicate with each other.There were 2 cases of tumor recurrence,1 case of intralaryngeal recurrence,1 case of cervical lymph metastasis recurrence.The recurrence rate was 10.0%(2/20),and the cumulative survival rates of 3 years and 5 years were 85.0%(17/20)and 80%(16/20)respectively.Conclusion The operation through paraglottic space is suitable for some laryngeal cancer involving the glottis and supraglottic area at the same time.The exposure of the tumor is clear,the resection is complete,and the laryngeal function can be effectively preserved.It is an ideal operation.