梨状窝癌切除与喉功能保留

1978年3月以来,作者对梨状窝癌采用了保守性喉咽切除术。用以整复喉咽缺损的方法是颈部皮瓣、胸三角皮瓣、游离微血管肠段移植、胸大肌皮瓣及胃上提等。喉的残存部分以颈部皮瓣、胸舌骨肌筋膜、会厌或残存会厌整复,使喉的功能,即发音、吞咽保护和呼吸全部恢复或恢复发音及吞咽保护部分功能。治疗的47例梨状窝癌患者获得了较好的治疗效果,5年存活率为41.7%,3年存活率50%,喉功能完全恢复31例,部分恢复16例。作者认为保留喉的未被累部分是可行的。不影响肿瘤切除的彻底性。

LARYNGEAL FUNCTION PRESERVATION IN SURGICAI TREATMENT OF CARCINOMA OF THE PYRIFORM SINUS

Since 11th March 1978,conservation laryngopharyngeal sur- gery has been used extensively in the treatment of carcinomas of the Pyriform sinus by the author.The methods for pharyngeal reconstruc- tion popular used were cervical skin flap,deltopectoral flap,free micro- vascular bowel transfer,and pectoralis major myocutaneous flap and gastric Pull-up.The remnants of the larynx were repaired by using cervical skin,sternohyoid myofascia,remnant epiglottis to rehabilitate the laryngeal functions completely(phonation,degluttition protection and respiration)or partially(phonation and degluttition protection). 47 patients with carcinoma of pyriform sinus were thus treated and fairly good therapeutic(5 year survival rate 41.7%,and 3 year survival rate 50%)and laryngeal function(restored completely in 31 cases and partially in 16 cases)results obtained. Suitabilities for conservation surgery and methods of laryngeal recon- structions are outlined and discussed.It is concluded that preservation of the unaffected part of the larynx is clearly reliable and effective for eradication of turnour as well as preservation of laryngeal function.