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目的:报告喉中段切除术治疗T2-3声门型喉癌的手术方式及临床应用结果,对手术效果与疗效进行分析。方法:1999年4月至2008年8月间38例经病理诊断的T2-3声门型喉癌行喉中段切除术,其中男32例,女7例,年龄42岁～69岁,平均年龄54.4岁,所有患者经喉中段切除术。术后对病人的进食、发音、拔管情况、肿瘤复发率及存活率进行观察。结果:随访病人(36例,失访3例)的5年生存率为91.67%(33/36),3例复发者行喉全切除术。16例术后20天拔除气管套管,1例术后1个月拔除气管套管。所有病例术后均一期愈合,未发生感染或咽瘘。术后进食时,仅行双侧喉中段切除的5例病例有轻度呛咳,于术后2-3周恢复正常进食,其余病例均未发生术后呛咳。所有病例术后均恢复语言功能,但行双侧喉中段切除的病人术后音强较小。结论:喉中段切除术治疗T2-3声门型喉癌是一种安全有效的手术方式,且能够较好的保留喉功能。
Objective: To report the surgical approach and clinical application of laryngectomy in the treatment of T2-3 glottic laryngeal cancer, and to analyze the surgical results and curative effect. Methods: From April 1999 to August 2008, 38 cases of pathologically diagnosed T2-3 glottic laryngeal carcinoma were treated by mid-laryngectomy, including 32 males and 7 females, ranging in age from 42 to 69 years. The mean age 54.4 years old, all patients underwent mid-laryngectomy. After the patient’s eating, pronunciation, extubation, tumor recurrence rate and survival were observed. Results: The 5-year survival rate of follow-up patients (36 cases, 3 cases lost to follow-up) was 91.67% (33/36). Three cases had recurrent laryngectomy. Twenty-six cases of tracheal tube were removed 20 days after operation and one case of tracheal tube was removed one month after operation. All cases were healed one after the operation, no infection or pharyngeal fistula. Postoperative eating, only 5 cases of bilateral resection of the middle of the larynx mild cough, 2-3 weeks after the return to normal eating, the rest of the cases were no postoperative cough. All cases were restored after language function, but the line of bilateral removal of the middle of the larynx patients after the sound intensity is relatively small. Conclusion: The middle laryngectomy for the treatment of T2-3 glottic laryngeal cancer is a safe and effective surgical approach, and can better retain laryngeal function.