中位喉切除术疗效分析

目的 探讨中位喉切除术的疗效。方法 分析我院1995年2月-2004年5月间行中位喉切除术的23例喉鳞状细胞癌患者（其中T1bN0M0 13例，T1bN1M0 4例，T2N0M0 4例，T2N1M0 2例），手术方式：充分暴露甲状软骨板后，以声带前联合为中点，向上下各0．5cm横行锯开甲状软骨板，切除中份甲状软骨板、双声带、前联合、双侧喉室，切缘距瘤体周边0．5cm以上，保留双侧杓状软骨。切断甲状软骨上角后，对位缝合室带与声门下、甲状软骨板上下断端。N1患者均行颈淋巴清扫，术后2例加行放化疗。结果 术后4周100％（23／23）完全恢复吞咽功能，术后拨管率95．7％（22／23）。拔管后能快跑者81．8％（18／22），能慢跑者18．2％（4／22）。术后喉腔局部复发率：3年10．5％（2／19），5年15．4％（2／13）。术后生存率：3年为94．7％（18／19），5年为84．6％（11／13）。结论 中位喉切除术术后能较好地恢复呼吸及吞咽功能，术后复发率及死亡率低，对T1b、T2级喉癌是可行的。

Application of middle laryngectomy in laryngeal cancer

OBJECTIVE To study the clinical effi- cacy of middle laryngectomy. METHODS Twenty three cases with laryngeal cancer were treated by middle laryngectomy in our hospital from Feb.1995 to May 2004, of whom 13 were T1bN0M0,4 were T1bN1M0,4 were T2N0M0,and 2 were T2N1M0. All N1 cases un- derwent neck dissection. RESULTS The decannulation rate was 95.7 %(22/23). All the cases resumed regular diets 4 weeks after operation (23/23)and had satisfied phonation. Local recurrence rates at 3 and 5 year after operation were 10.5 %(2/19)and 15.4 %(2/13)respectively. The 3- and 5-year survival rates were 94.7 %(18/19) and 84.6 %(11/13) respectively. CONCLUSION Respiratory and swallowing function can be well rehabilitated after the middle laryngectomy. The recurrence rate was very low. The T1b and T2 glottic cancer was the indication for middle laryngectomy.