喉部分切除术的临床应用

①目的　探讨喉癌病人保留喉功能喉部分切除手术方法、修复材料的选择。②方法　378 例喉癌病人分别行不同术式喉部分切除,同期采用颈前皮瓣、颈深筋膜浅层筋膜瓣、会厌瓣、颈前带状肌肌瓣、会厌瓣+双蒂肌瓣联合多种方法和不同材料修复喉缺损。145 例同期行颈淋巴结清扫术。③结果　全部病人于术后 10~25 d进食。术后拔管率为83.59%。34例发生术后感染,其中 12 例发生咽瘘。3、5 年生存率分别为 80.7%、64.8%。④结论　喉癌的早期诊断、早期治疗是提高疗效的关键因素,喉部分切除术+Ⅰ期喉功能重建可提高病人的生存率,改善病人的生活质量,值得临床推广应用。

CLINICAL APPLICATION OF PARTIAL LARYNGECTOMY

Objective To study the operative methods, repairing materials for reconstruction of partial laryngectomy on patients with laryngeal carcinoma. Methods A partial laryngectomy was done for 378 patients with laryngeal cancer by applying different operating patterns and the laryngeal defects were reconstructed by either myocutaneous flap of neck, facial flap of deep facial of neck, epiglottic flap, bi-pedicle muscle flap or epiglottic flap plus bi-pedicle muscle flap. A radical neck dissection was carried out simultaneously in 145 patients. Results All the patients began eating 10-25 days after operation. The decannulation rate was 83.59%. Wound infection occurred in 34 cases, including 12 pharyngocutaneous fistula. The three- and five-year survival rates were 80.7% and 64.8%, respectively. Conclusion Early diagnosis and treatment are the key points of improvement of the treatment outcome. Partial laryngectomy plus one-stage reconstruction of the throat may increase survival rate and improve the quality of life of patients, which is highly recommended clinically.