保留喉功能的T3声门癌的手术治疗

目的：探讨T3声门癌喉功能保留手术的方法和临床疗效。方法：对75例T3声门癌患者进行手术治疗，切除肿瘤后以会厌、双蒂接力肌甲状软骨膜瓣、颈阔肌皮瓣、胸骨舌骨肌筋膜瓣、颈阔肌筋膜瓣、甲状软骨膜瓣等修复组织缺损并重建喉功能。结果：全组病例3年生存率83．2％，5年生存率73．6％。62例患者于术后2周～6个月拔除气管套管，拔管率为82．7％。结论：T3声门癌在彻底切除肿瘤的前提下保留喉功能是可行的。熟练掌握多种修复方法，择优采用，是恢复良好的喉功能的重要保证。

Preservative surgery of T3 glottic cancer:75 cases report

Objective:To explore the methods of surgery and evaluate the long term result of preservative surgery for T 3 glottic cancer.Method:Seventy five cases with T 3 glottic cancer were treated surgically from 1989 to 1999.The lesions were removed entirely, the epiglottis, bi pedicled myoperichondral flap, platysma myocutaneous flap, sternohyoid myofascial flap, platysma myofascial flap, thyroid perichondral flap were utilized to restore the defects of larynx and reconstruct the laryngeal functions.Result:The 3 and 5 year survival rates were 83.2 % and 73.6 % in all cases. 82.7 % had all laryngeal functions(voice, respiration and deglutition) restored and 17.3 % partially restored(voice and deglutition).Conclusion:Preservative surgery can be carried out for T 3 glottic cancer with the lesions entirely removed. Choosing and following what is optimum from multiple feasible surgical methods is a prerequisite for better laryngeal functions.