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目的:评价喉垂直切除会厌下移喉重建术(Tucker技术)治疗早期声带癌(T1b,T2)的效果,明确Tucker技术的手术适应证。方法:回顾性分析139例接受Tucker技术治疗患者的临床资料,其中127例是首次接受治疗的患者(T1b48例,T279例),12例(Tr)是声带癌曾接受过放射治疗或声带切除后复发的患者。计算生存率和评估喉功能恢复情况。结果:T1期患者的5年生存率为91.0%,肿瘤局部控制率为100%;T2期患者的5年生存率为86%,肿瘤局部控制率为94.0%;Tr期患者的5年生存率为64.0%,肿瘤局部控制率为82%。喉功能保留方面:气管拔管率为100%,平均拔管时间10d。胃管拔除率为99.3%(138/139),6例因误咽施行了胃造漏术,1例因顽固性误咽导致吸入性肺炎施行了功能性全喉切除术;平均胃管拔管时间为15d。121例(87.1%)患者获得了好或较好的发声,18例患者的发声质量较差如同耳语声。结论:喉垂直切除会厌下移喉重建术(Tucker技术)是治疗T和T期声带癌的有效手术方法。
PURPOSE: To evaluate the effect of vertical excision of the larynx on Tucker technique in the treatment of early stage vocal cord cancer (T1b, T2) and to identify the surgical indications of Tucker technique. Methods: A retrospective analysis of 139 cases of patients receiving Tucker technology clinical data, of which 127 cases were the first treatment of patients (T1b48 cases, T279 cases), 12 cases (Tr) is the vocal cord cancer who have undergone radiotherapy or vocal cord excision Recurrence of patients. Calculate survival rates and assess recovery of laryngeal function. Results: The 5-year survival rate was 91.0% in T1 stage and 100% in tumor control group. The 5-year survival rate was 86% in T2 stage and 94.0% in tumor control group. The 5-year survival rate in T1 stage Was 64.0%, the tumor local control rate was 82%. Laryngeal function retention: tracheal extubation rate of 100%, the average extubation time 10d. Gastric tube removal rate was 99.3% (138/139), 6 cases of gastric leakage caused by misdiagnosis and 1 case of functional total laryngectomy due to intractable aphasia caused by aspiration pneumonia; mean gastric tube extubation The time is 15d. In 121 (87.1%) patients, good or better vocalizations were obtained, and 18 patients had poor vocalizations as whispering. CONCLUSIONS: Vertical laryngectomy and tucker reconstruction (Tucker technique) are effective surgical methods to treat stage T and stage V vocal cord cancer.