喉水平垂直部分切除术治疗晚期喉癌

目的　评价喉水平垂直部分切除术治疗晚期 (T3 ,T4 )喉癌的效果。方法　回顾性分析1984～ 1994年采用该术式治疗的 5 7例T3 、T4 病例的生存率和喉功能保留情况。结果　本组病例 3年生存率为 70 % (40 / 5 7) ,5年生存率为 6 4% (32 / 5 0 )。本组患者均保留了发音功能 ,需带管呼吸者 4例 ,拔管率为 93% (5 3/ 5 7) ,经过鼻饲和使用带气囊气管套管锻炼 ,患者均可经口进食。清楚死亡原因的病例共 14例 :局部复发死亡 4例 ,颈淋巴结转移死亡 4例 ,远隔转移死亡 4例 ,非肿瘤原因死亡 2例。失访 4例。结论　只要适应证选择的合理 ,该术式对一部分T3 、T4 喉癌的治疗即可根治肿瘤 ,又可保留喉的功能 ,单纯的高龄因素不是该术式的禁忌证。

Horizontal-verticalhemilaryngectomy for advanced laryngeal cancer

Objective To evaluate the adequacy of horizontol vertical partial laryngectomy in the treatment of advanced laryngeal cancer Methods We retrospectively reviewed 57 patients with advanced laryngeal cancer (T 3 or T 4 on the primary site) treated by horizontal vertical hemilaryngectomy. Fifty six patients underwent neck dissections. Results The overall 3 and 5 year survival rates were 70%(40/57) and 64%(32/50),respectively All patients had good phonation and resumed mouth feeding after surgery Among all the deaths, 4 died of recurrence of laryngeal cancer, 4 cervical metastasis, 4 distant metastasis, 2 intercurrent disease and 3 unknown. Of 36 patients with N 0 neck, fifteen cases (15/36, 41.6%) had lymph node metastases pathologically. Conclusion Horizontal vertical hemilaryngectomy is satisfactory for the treatment of selected advanced laryngeal cancers It also preserves laryngeal functions in most cases