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喉全切除术在治疗中晚期喉癌中的应用
引用本文:柳斌,潘子民,季文樾. 喉全切除术在治疗中晚期喉癌中的应用[J]. 临床耳鼻咽喉头颈外科杂志, 2005, 19(24): 1105-1108
作者姓名:柳斌  潘子民  季文樾
作者单位:中国医科大学附属第一医院耳鼻咽喉科,沈阳,110001;中国医科大学附属第一医院耳鼻咽喉科,沈阳,110001;中国医科大学附属第一医院耳鼻咽喉科,沈阳,110001
摘    要:目的:探讨喉全切除术治疗中、晚期喉癌的疗效。方法:对573例喉癌患者行喉全切除术,声门上型370例,声门型90例,跨声门型75例,声门下型21例,放疗后复发17例。其中143例行单纯喉全切除术,430例同期行颈廓清术(单侧239例,双侧191例)。在喉全切除术中行气管外口造大孔术,共308例。结果:3、5及10年生存率分别为69.5%(398/573),61.1%(350/573),46.3%(149/322);220例死亡病例中,45.0%(99/220)死于局部复发;22.3%(49/220)死于颈部转移。术腔感染和咽瘘的发生率分别为12.2%,5.2%。16.6%气管外口造大孔术患者气管外口再度狭窄需行Ⅱ期气管外口扩大术或戴套管维持呼吸。13.6%的患者可以行喉部分切除术,由于不同的原因行喉全切除术。结论:喉全切除术作为治疗中、晚期喉癌的主要手段,其适应证随喉癌外科技术的发展而逐渐缩小。在采取积极的颈廓清术情况下,局部复发是主要的死亡原因。

关 键 词:喉肿瘤    鳞状细胞  喉切除术
文章编号:1001-1781(2005)24-1105-04
收稿时间:2005-05-10
修稿时间:2005-05-10

Total laryngectomy in advanced stage laryngeal carcinoma
LIU Bin,PAN Zimin,JI Wenyue. Total laryngectomy in advanced stage laryngeal carcinoma[J]. Journal of clinical otorhinolaryngology, head, and neck surgery, 2005, 19(24): 1105-1108
Authors:LIU Bin  PAN Zimin  JI Wenyue
Affiliation:Department of Otorhinolaryngology, the First Affiliated Hospital of China Medical University, Shenyang. liubincmu@163.com
Abstract:Objective:To summarize the effects of total laryngectomy in advanced stage laryngeal carcinoma in the fourteen years in our hospital.Method:Five hundred and seventy-three patients with laryngeal carcinoma who underwent total laryngectomy were studied retrospectively. Among them 143 cases underwent total laryngectomy and the other 430 cases underwent simultaneous neck dissection, 239 cases ipsilateral and 191 cases bilateral. Enlarged tracheal fistula was applied in 308 cases from 1989.Result:Three,five and ten year survival rates were 69.5%, 61.1% and 46.3% respectively. Among 220 patients who died during follow up, 45.0% died from local recurrence and 22.3% died from cervical lymph node metastasis. Local infection and pharyngeal fistula rate were 12.2% and 5.2% respectively. 16.6% patients who underwent enlarged tracheal fistula needed secondary operation or wearing cannula because of narrowed fistula. Partial laryngectomy could be applied to 13.6% patients but total laryngectony was done to those patients because of different reasons.Conclusion:Total laryngectomy is still a major treatment in advanced stage laryngeal carcinoma but its indications are decreasing gradually with the development of surgical technique. Although positive attitude of neck dissection was taken,local recurrence was the main reason of death.
Keywords:Laryngeal neoplasms  Carcinoma   squamous cell  Total laryngectomy
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