累及双侧喉腔的T_2声门癌的手术治疗

Surgical management of bilateral T_2 glottic cancer

目的 :探讨累及双侧喉腔的T2 声门癌的手术方法和临床疗效。方法 :对 2 2例累及双侧喉腔的T2声门癌患者行额侧喉部分切除术 ,以会厌、双蒂接力肌甲状软骨膜瓣、颈阔肌皮瓣、胸骨舌骨肌筋膜瓣、甲状软骨膜瓣、胸锁乳突肌骨膜瓣等修复组织缺损并重建喉功能。结果 :全组病例 3年生存率为 90 .9% (2 0 / 2 2 ) ,5年生存率为 88.9% (16 / 18)。喉功能全恢复 (吞咽保护、呼吸、发声 )为 90 .9% (2 0 / 2 2 ) ,喉功能部分恢复 (吞咽保护、发声 ) 9.1% (2 / 2 2 )。结论 :额侧喉部分切除术是治疗累及双侧喉腔的T2 声门癌的较好方法 ,肿瘤切除彻底 。

Objective:To explore the surgery method and evaluate the long-term result of surgery for bilateral T 2 glottic cancer. Methods: 22 cases with bilateral T 2 glottic cancer were treated with frontal partial laryngectomy.The lesions were removed entirely, the epiglottis , bi-pedicled myoperichondral flap, platysma myocutaneous flap, sternohyoid myofascial flap, thyroid perichondral flap and sternocleidomastoid myoperiosteal flap were utilized to restore the defects of larynx and reconstruct the laryngeal functions. Result: The 3-and 5-year survival rates were 90.9% and 88.9% in all cases. 90.9% had all laryngeal functions(voice, respiration and deglutition) restored and 9.1% partially restored(voice and deglutition).Conclusion:Frontal partial laryngectomy is a practical method for bilateral T 2 glottic cancer,not only the lesions can be removed entirely,but also the laryngeal function can be preserved well.