保留杓状软骨喉次全切除喉功能重建的体会

目的　探讨应用保留杓状软骨的喉次全切除喉功能重建术治疗T3 喉癌 (声门及声门上型 )的拔管率和 3、5年生存率。方法　对 2 0例T3 级喉癌 ,其中声门型 3例 (T3 N0 M0 )、声门上型 17例(T3 N1 M0 5例 ,T3 N0 M0 12例 ) ,根据病变范围行保留单侧或双侧杓状软骨喉次全切除及功能重建术 ,并设计环咽吻合术式。结果　 3、5年生存率分别为 16/ 17(94 1% )和 11/ 12 (91 8% )。全部患者均恢复了吞咽和发音功能 ,拔管率为 95 0 %。结论　保留杓状软骨喉次全切除及功能重建术是治疗T3 喉癌的一种很好术式。手术的关键是不能损伤杓状软骨及喉返神经 ,设计好环咽吻合方案。

The reconstruction of laryngeal function in subtotal laryngectomy with preservation of arytenoid cartilage

Objective To evaluate subtotal laryngectomy with preservation of arytenoid cartilage to reconstruct laryngeal function in T 3 glottic or supraglottic laryngeal cancer Methods Subtotal laryngectomy with preservation of arytenoid cartilage to reconstruct laryngeal function was reviewed in 20 patients with T 3 laryngeal cancer(3 cases with glottic cancer and 17 cases with supraglottic cancer) Recurrent laryngeal nerve was preserved during surgery The mucous membranes between cricoid cartilage and pharynx were sewed up accordingly Results All patients had restored phonation and swallowing functions The 3 and 5 year survival rates were 94 1% and 91 8% respectively Decannulation rate was 95.0% Conclusion Subtotal laryngectomy with preservation of arytenoid cartilage is recommended for T 3 laryngeal cancer