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目的 评价保留下颌骨下缘和舌骨上淋巴清扫舌癌根治术式的可行性及适应证。方法 回顾总结10例采用该术式舌癌病例临床资料。结果 3例在术后2个月～1年半发现患侧颈淋巴转移;2年生存者9例,3年生存者4例,5年生存者2例;所有病例均无局部复发。结论 保留下颌骨下缘更有利于舌原发灶的彻底切除,避免局部复发,对未侵犯下颌骨的病例均可采用。舌骨上淋巴清扫术应慎重应用,手术应扩展至二腹肌淋巴结。术后配合系统化疗并严密观察,一旦发现颈淋巴转移灶立即行根治性颈淋巴清扫术。
Objective To evaluate the feasibility and indications of radical mastectomy for preserving the lower margin of the mandible and suprahyponactic lymphoid dissection. Methods The clinical data of 10 cases with tongue cancer were retrospectively reviewed. Results Three cases of ipsilateral cervical lymphatic metastasis were found from 2 months to 1 year and a half after operation. There were 9 cases of 2-year survivors, 4 cases of 3-year survivors and 2 of 5-year survivors. No local recurrence was found in all cases. Conclusion Keep the lower edge of the mandible is more conducive to the complete removal of the primary tumor of the tongue, to avoid local recurrence of cases of non-violation of the mandible can be used. Tongue lymphatic dissection should be carefully applied, surgery should be extended to the abdominal muscles lymph nodes. Combined with systemic chemotherapy and close observation, once found, neck lymphoid metastases immediately after radical neck dissection.