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目的 :探讨晚期甲状腺癌累及喉、气管时的一期手术整复方法。方法 :对 18例存在喉气管受累的晚期甲状腺癌患者进行一期肿瘤全切及喉气管整复 ,其中 7例喉受累患者全喉切除 3例 ,喉部分切除 4例 ;18例颈段气管受累患者中 ,8例直接切除肿瘤 ,10例切除受累气管壁后 ,修复方法包括 :拉拢缝合 1例、端端吻合 3例、带蒂胸锁乳突肌骨膜瓣 2例、岛状胸大肌肌皮瓣 3例和颈部皮瓣 1例。结果 :住院期间肿瘤复发死亡 1例。除 3例全喉切除患者外 ,14例成功保留喉功能 ,其中拔除气管套管 8例 ,堵管 2例 ,继续带管 4例。结论 :对于累及喉气管的晚期甲状腺癌采用一期手术切除并整复不仅切实可行 ,而且可以提高此类患者的治愈机会 ,改善生活质量
Objective: To investigate the surgical treatment of advanced thyroid cancer involving the larynx and trachea. Methods: Tumor resection and laryngotracheal tube repair were performed in 18 patients with advanced thyroid cancer with laryngotracheal involvement. Among them, laryngectomy was performed in 3 of 7 laryngectomies and in 4 of laryngectomies in 7 laryngeal patients. Tracheal involvement in 18 patients Among the patients, 8 had direct resection of the tumor and 10 had resection of the affected tracheal wall. The repair methods included: suture and suture in 1, anastomosis in 3, pedicle sternocleidomastoid flap in 2, pectoralis major 3 cases of flap and 1 case of neck flap. Results: One patient died of tumor recurrence during hospitalization. In addition to 3 cases of total laryngectomy, 14 cases successfully retained laryngeal function, including removal of tracheal tube in 8 cases, occlusion in 2 cases, and continue to take the tube in 4 cases. Conclusion: It is not only practical and feasible to use one-stage surgical resection and reconstruction of advanced thyroid cancer involving laryngotracheal tube, but also to improve the chance of cure and improve the quality of life of such patients