环上喉次全切除喉功能重建41例的疗效分析

Supracricoid subtotal laryngectomy with laryngeal reconstruction for laryngeal cancers

目的 :探讨环上喉次全切除喉重建术的治疗效果和喉功能重建效果。方法 :回顾性分析 4 1例接受该术式的T2 ～T4期喉鳞癌患者的临床资料。其中声门型 35例 ,声门上型 6例 ;行环舌会厌固定术 2 3例 ,环舌固定术 18例。结果 :3年生存率 83.3% (30 / 36 ) ,5年生存率 71.4 % (2 0 / 2 8) ;拔管率为 92 .7% (38/ 4 1)。 1例因误吸严重而行咽气管分离术 ,余 4 0例均恢复了正常吞咽。全部患者均能利用新喉发音。结论 :环上喉次全切除喉功能重建术既能彻底切除肿瘤 ,又能恢复喉的三大基本功能 ,是中、晚期喉癌治疗的有效方法之一。

Objective:To assess the effectiveness of supracricoid subtotal laryngectomy in the treatment of laryngeal cancer and the reconstructed laryngeal functions. Method:A retrospective review was made on 411 aryngeal caner patients in the stage T 2 to T 4 treated by this surgical procedure form 1985 to 2000. In these cases, 35 were glottic cancers, 6 were supraglottic cancers, 23 patients were performed by supracricoid subtotal Laryngectomy with cricohyoidoepiglottopexy, 18 were performed with cricohyoidopexy. Result:Over 3 year and 5 year survival rates were 83.3 %(30/36) and 71.4 % (20/28). Decannulation rate was 92.7 % (38/41). 40 patients resumed normal oral feeding but one was still performed an operation to separate the tracheal from pharynx because of the severe aspiration. All cases were able to speak by the new larynx. Conclusion:Supracricoid subtotal laryngectomy with laryngeal reconstruction was not only completely removal of tumors, but also restored the three physiological functions of larynx. It is an effective treatment for laryngeal cancer.