[T4期声门癌的保喉手术]
[Preservative surgery of T4 glottic cancer].
作者信息
Zhang Liqiang, Luan Xinyong, Pan Xinliang, Xie Guang, Xu Fenglei, Liu Dayu, Lei Dapeng, Wang Tianduo
机构信息
Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan 250012, China.
出版信息
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2002 Aug;37(4):300-3.
OBJECTIVE
To explore new methods of preservative surgery for T4 glottic cancer and to evaluate their long term results.
METHODS
22 cases with T4 glottic cancer were treated surgically from 1982 to 1998. The lesions and involved cartilage and extrinsic laryngeal tissues were removed entirely, the sternohyoid myofascial flap, platysma myocutaneous flap, platysma myofascial flap, thyroid perichondral flap and hypopharyngeal mucosa flap were utilized to restore the defects of larynx, while the epiglottis or lamina of cricoid cartilage were reserved for laryngeal function restruction.
RESULTS
The 3- and 5-year survival rates were 86.4% and 75.0% in all cases. 68.2% had laryngeal functions(voice, respiration and deglutition) restored and 31.8% partially restored(voice and deglutition).
CONCLUSION
Despite the fact that the T4 glottic cancer usually involved with cartilage and extrinsic laryngeal tissues, preservative surgery can be carried out for the carefully selected cases with the lesions entirely removed.
目的
探索T4声门癌保喉手术的新方法并评估其长期效果。
方法
1982年至1998年对22例T4声门癌患者进行手术治疗。完整切除病变组织及受累软骨和喉外组织，利用胸骨舌骨肌筋膜瓣、颈阔肌肌皮瓣、颈阔肌肌筋膜瓣、甲状腺软骨膜瓣及下咽黏膜瓣修复喉缺损，同时保留会厌或环状软骨板以恢复喉功能。
结果
所有患者3年和5年生存率分别为86.4%和75.0%。68.2%患者的喉功能（发音、呼吸和吞咽）得以恢复，31.8%患者部分恢复（发音和吞咽）。
结论
尽管T4声门癌通常累及软骨和喉外组织，但对于精心挑选且病变能完整切除的病例可实施保喉手术。
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