喉声门上水平部分切除术在声门上喉癌治疗中的应用

目的评价喉声门上水平部分切除术对声门上喉癌的治疗作用。方法回顾性分析了１０７例声门上型喉癌行水平部分切除术的治疗结果。男性６９例,女性３８例。年龄在３８～８０岁之间,平均年龄５１．４岁。手术适应证选择包括声门上Ｔ１病变、未累及声带的Ｔ２病变和累及会厌前间隙及梨状窝内壁的Ｔ３病变;舌会厌谷受累的Ｔ４病变同期切除部分舌根。结果术后气管套管拔除率９２．２％。发音满意率为９１．６％。Ｉ、ＩＩ、ＩＩ和ＩＶ期５年生存率分别为１００．０％、８３．３％、７１．７％和４１．７％。结论各期声门上型喉癌经适当选择,可采用声门上水平部分喉切除术,根治率较好而喉功能得以保留。对于颈部Ｎ０患者不应一律行颈淋巴结清除术;上颈淋巴结清除术作为诊断措施,效果肯定,可避免不必要的全颈淋巴结清除术。

Supraglottic horizontal laryngectomy for supraglottic carcinoma

Objective To evaluate the therapeutic results of supraglottic horizontal laryngectomy (SHL) for T 1 and selected T 2, T 3 and T 4 supraglottic carcinoma. Methods One hundred and seven patients undergone SHL during the period of 1979 through 1991 were reviewed retrospectively. All patients were followed up for at least 5 years. Results The 5 year survival rate of 6 cases in stage I, 24 cases in stage II, 53 cases in stage III, and 24 cases in stage IV was 100.0%, 83.3%, 71.7% and 41.7%, respectively. Of the 102 patients, 92.2% were decannulated, and 91.6% of all patients achieved satisfactory recovery of phonation. Conclusion SHL is a reliable surgical approach for selected supraglottic carcinoma, even for some advanced lesions, provided the tumor has not extended below the ventricle. The upper neck dissection can be used as an exploratory measure. For N 0 neck patients with supraglottic cancer, comprehensive neck dissection is not invariably performed to avoid overtreatment.