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目的:探讨累及声门旁间隙的梨状窝癌喉功能保存手术的可行性和治疗效果。方法:回顾性分析14例累及声门旁间隙梨状窝癌患者的临床资料。手术切除病变组织后行喉成形,同时行双侧选择性颈清扫术。术后3例患者未接受放化疗,其余11例均行放化疗。术后随访6个月~5年,平均3年6个月。结果:12例患者切口一期愈合,2例咽瘘经换药后痊愈。患者均有术后吞咽呛咳,最迟术后2个月拔胃管经口进食。11例术后放化疗者中10例随访3年未见复发,1例复发未治疗后死亡。3例未接受放化疗者中,2例在6个月内复发,行放化疗后1例未见复发,1例失访;1例术后8个月复发,行全喉切除术,术后放化疗,首次术后1年6个月死亡。3年生存率为78.6%;患侧声带6例有轻微动度,8例无明显声带解剖标志。结论:选择适当病例,对累及声门旁间隙的梨状窝癌患者行喉功能保存手术,可取得较好的临床效果,使患者有更好的生存质量。
Objective: To investigate the feasibility and therapeutic effect of preservation of laryngeal function in patients with popliteal laryngeal carcinoma involving the paraglottic glottic space. Methods: A retrospective analysis of 14 cases of patients with subglottic crevice popliteal carcinoma involving the clinical data. Surgical removal of the lesion after laryngeal surgery, simultaneous bilateral selective neck dissection. After surgery, 3 patients did not receive radiotherapy and chemotherapy, the remaining 11 patients underwent radiotherapy and chemotherapy. Follow-up 6 months to 5 years, an average of 3 years and 6 months. Results: The incisions of 12 patients healed in one period, and two cases of pharyngeal fistula healed after dressing change. Patients had postoperative swallow cough, at the latest 2 months after gastric tube pull oral intake. Of the 11 patients who received radiotherapy and chemotherapy, 10 patients were followed up for 3 years without recurrence, and 1 patient died of recurrence after treatment. Of the 3 patients who did not receive radiochemotherapy, 2 patients relapsed within 6 months. One patient had no recurrence after radiotherapy and chemotherapy and one patient lost follow-up. One patient recurred 8 months after operation and underwent total laryngectomy. After operation, Radiotherapy and chemotherapy, the first postoperative 1 year and 6 months of death. 3-year survival rate was 78.6%; ipsilateral vocal cord in 6 patients had a slight movement, 8 cases no obvious vocal cord anatomy. CONCLUSIONS: Choosing the appropriate cases, laryngeal preserving surgery for patients with infiltrating popliteal gland involving the glottic paragang space can achieve better clinical results and better quality of life for patients.