环上喉切除喉功能重建术78例疗效分析

目的回顾20年来对喉声门癌保留会厌的环上喉切除喉功能重建的远期疗效,研究这一手术的可行性和保证患者生活质量的效果.方法随访1980年1月～1996年1月期间行环上喉切除保留会厌喉功能重建术78例,总结统计其手术疗效.结果78例患者中,随访3年时有68例存活,2例死于肿瘤复发,8例死于其它疾病,3年生存率87.2%.随访5年有59例存活,5年生存率75.6%(59/78).随访满10年的38例患者中有8例存活,占21.1%.存活满20年者2例.术后拔管率提高到97.4%(76/78).患者恢复了正常吞咽功能,且喉的发音功能理想.结论改良的保留会厌环上喉切除环咽吻合喉功能重建术既能彻底切除肿瘤,又重建喉功能,提高了患者的生存质量,值得推广.

Retrospective analysis of supracricoid partial laryngectomy with epiglottis preserved and reconstruction of laryngeal function

Objective To retrospectively evaluate the curative and functional consequences of supracricoid partial laryngectomy with epiglottis preserved. Methods From 1980 to 1996, 78 patients underwent supracricoid partial laryngectomy with the epiglottis preserved. The survival rate and the functional results were analyzed. Results Overall three year survival rate was 87.2%(68/78), overall five year survival rate was 75.6%(59/78), and ten year survival rate was 21.1%(8/38). All patients resumed normal oral feeding. 97.4%(76/78) achieved tracheal extubation. Respiratory and speaking functions were good. Conclusion Supracricoid partial laryngectomy with epiglottis preserved and reconstruction of laryngeal function not only improved local cancer control, but also preserves laryngeal physiologic function.