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目的 探讨声门下喉癌部分喉手术治疗的方法及其疗效。方法 对 9例 1984年3月—1999年 3月手术治疗的声门下喉癌患者进行分析。按 1997年UICC修订案分期,Ⅱ期 (T2N0)2例,Ⅲ期(T3N0)2例,Ⅳ期 5例(T3N1 1例,T4N0 3例,T4N1 1例)。所有病例采用带蒂甲状软骨下移错位支架成形重建肿瘤切除后的软骨支架,分别应用甲状舌骨肌为蒂、胸骨甲状肌为蒂、咽下缩肌为蒂的甲状软骨下移。全部行颈清扫术。结果 9例患者全部保留了喉功能,发音良好。8例拔除气管套管, 1例未能拔管,拔管率 8 /9;全部患者恢复经口进食,无明显呛咳及吞咽困难。3年生存率8 /9, 5年生存率 6 /9。结论 对适合的声门下癌应用带蒂甲状软骨下移错位支架喉成形术,手术创伤小,一期形成软骨支架,带蒂软骨容易成活,提高了拔管率和喉功能的保留率,对声门下癌是一种可行的治疗方法。
Objective To investigate the methods and curative effects of partial laryngeal surgery for subglottic laryngeal cancer. Methods Nine patients with subglottic laryngeal cancer undergoing surgery from March 1984 to March 1999 were analyzed. According to the revised UICC 1997, there were 2 cases of stage Ⅱ (T2N0), 2 cases of stage Ⅲ (T3N0), 5 cases of stage Ⅳ (1 case of T3N1, 3 cases of T4N0 and 1 case of T4N1). In all cases, the cartilage scaffold after reconstruction was reconstructed with pedicled thyroid cartilage. The thyroid cartilage pedicled on the thyroid hyoid muscle, the sternum thyroid muscle pedicled, and the sarcopenic muscle was used for descending thyroid cartilage. All neck dissection. Results All 9 patients retained the laryngeal function, pronounced well. In 8 cases, tracheal cannula was removed, one case failed to extubate and the rate of extubation was 8/9. All patients recovered oral intake without obvious cough and dysphagia. 3-year survival rate of 8/9, 5-year survival rate of 6/9. Conclusions The application of pedicled thyroid cartilage to the suitable subglottic carcinoma underwent surgical thoracoplasty with less trauma and a cartilage scaffold. The pedicled cartilage is easy to survive and improves the rate of extubation and retention of laryngeal function. Subciliary cancer is a viable treatment.