喉部分切除术的远期疗效观察

目的 观察喉部分切除术的远期疗效及喉功能的恢复情况。方法 总结１９８６～１９９５年间各种喉部分切除术３７９例，男２９０例，女８９例。声门上癌１８４例（按１９９２年ＵＩＣＣ标准Ｔ１８例，Ｔ２１１５例，Ｔ３４８例，Ｔ４１３例），声门癌１９２例（Ｔ１１１５例，Ｔ２６３例，Ｔ３１３例，Ｔ４１例），跨声门癌３例（Ｔ２１例，Ｔ３２例）。共８种术式，即声带切除术２６列，垂直部分切除术１３８例，额侧切除术７例，声

Long-term follow-up result of partial laryngectomy]

OBJECTIVE: To study the long-term follow-up result of partial laryngectomy and reservation of laryngeal function. METHODS: Three hundred and seventy-nine patients who underwent partial laryngectomy from 1986 to 1995 were summarized (male 290 cases, female 89 cases). Among them, 184 cases were supraglottic carcinomas (T1 8 cases, T2 115, T3 48, T4 13, according to UICC in 1992), 192 cases were glottic carcinomas (T1 115, T2 63, T3 13, T4 1), 3 cases were transglottic carcinomas (T2 1, T3 2). In common 8 kinds of operations were performed: 26 cases underwent cordectomy, 138 vertical laryngectomy, 7 frontolateral laryngectomy, 12 horizontal glottic laryngectomy (middle part of the larynx), 58 supraglottic laryngectomy, 95 horizontovertical (3/4) laryngectomy, 24 subtotal laryngectomy with cricoglossoepiglottic anastomosis, 19 near-total laryngectomy with cricoglossal anastomosis (with reservation of unilateral arytenoid cartilage). 193 cases underwent concurrent neck dissection(121 unilateral, 72 bilateral). RESULTS: All cases restored their phonation and overcame aspiration with removing nasal feeding from 7 to 23 days after operations. 362 cases were decannulated from 9 days to 3 months after operations. Another 8 cases were decannulated after a secondary plastic operation. Decannulation rate was 97.6%. The three, five and ten year survival rates were 86.8% (329/379), 81.3% (266/327) and 69.4% (120/173) respectively. CONCLUSION: Partial laryngectomy is a kind of radical operation with reservation of laryngeal function. Mastering indications strictly, correct operation choices, excellent surgical skills and perfect repairing technique are bases of improving life qualities and curative effect.