Luna-Ortiz Kuauhyama, Granados García Martín, Veivers David, Pasche Philippe, Tamez Velarde Mario, Herrera Gómez Angel, Barrera Franco José Luis
Department of ORL, Royal North Shore Hospital, Sidney, Australia.
Rev Invest Clin. 2002 Nov-Dec;54(6):515-20.
To present the preliminary results in our institute with supracricoid laryngectomy with cricohyoidoepiglotopexy (CHEP), as well as to evaluate possible short-term complications.
This study included eight patients with diagnosis of squamous cell carcinoma of the larynx glottic region (three patients were in stage I, two in II and three in III). Histologic grade was well differentiated in three patients, moderately differentiated in four and poorly differentiated in one.
Supracricoid laryngectomy with cricohyoidoepiglotopexy were performed in all cases, and bilateral elective functional neck dissection was done in 6 patients. Both cricoarytenoid units were preserved in 6 patients and only one in the other two cases. Mean time of hospitalization was 11 days. Mean time of decanulation was 12 days for the whole group; however, in those patients that preserved both cricoarytenoid units, the mean time of decanulation was 6 days, and in those that preserved one cricoarytenoid unit it was 31 days. Physiologic phonation was achieved in all patients at the moment of decanulation. Mean time for remotion of nasogastric sonde was 25 days, and it was 17 days for those who preserved both cricoarytenoid units and for patients with one cricoarytenoid unit it was 46 days.
Supracricoid laryngectomy with cricohyoidoepiglotopexy allows to preserve the basic functions of the larynx (respiration, degluttion and phonation), as well as the reintegration of affected patients to social life. All patients must be evaluated carefully in order avoid changing the stage or the surgical plan due to substadification of the tumor.
展示我院采用环状软骨上喉切除术联合环状软骨舌骨会厌固定术(CHEP)的初步结果,并评估可能的短期并发症。
本研究纳入8例诊断为声门区喉鳞状细胞癌的患者(3例为Ⅰ期,2例为Ⅱ期,3例为Ⅲ期)。组织学分级中,3例为高分化,4例为中分化,1例为低分化。
所有病例均行环状软骨上喉切除术联合环状软骨舌骨会厌固定术,6例行双侧选择性功能性颈淋巴结清扫术。6例患者的双侧环杓单位得以保留,另外2例仅保留1个。平均住院时间为11天。全组平均拔管时间为12天;然而,保留双侧环杓单位的患者平均拔管时间为6天,保留1个环杓单位的患者则为31天。所有患者在拔管时均实现生理性发声。鼻饲管拔除的平均时间为25天,保留双侧环杓单位的患者为17天,保留1个环杓单位的患者为46天。
环状软骨上喉切除术联合环状软骨舌骨会厌固定术能够保留喉部的基本功能(呼吸、吞咽和发声),并使受影响患者重新融入社会生活。必须对所有患者进行仔细评估,以避免因肿瘤分期不准确而改变分期或手术方案。