Liu Yehai, Tang Pingzhang, Qi Yongfa, Xu Zhengang
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Science, Beijing Union Medical University, Beijing 100021, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2002 Oct;37(5):380-3.
To study effective prevention and treatment of stoma recurrence after laryngectomy.
A retrospective review of 23 patients with stomal recurrence after laryngectomy was conducted. Among all 23 cases, 20 cases were referred to Cancer Hospital of Chinese Academy of Medical Science from other hospitals. The etiopathology of stomal recurrence after laryngectomy, feasibilities of various kinds of operative treatment and outcomes of clinical management in this series were analyzed.
The subglottic extension and invasion of paraglottic portion of laryngeal cancer and peritreacheal metastasis may result in stomal recurrence. The survival period of 18 cases surgically treated was longer than that of 5 cases untreated or irradiated and/or chemotherapied. The 1- and 5-year survival rates were 40.7% and 20.4%, respectively. The common complication was pharyngeal fistula. Surgical treatment may relieve local pain, improve breathing, resume swallowing and decrease cancer ulcer bleeding.
The overall prognosis of peristomal recurrence after laryngectomy was awful and dismal. Prevention should be stressed in surgical treatment of the subglottic extension, invasion of paraglottic portion and peritreacheal node metastasis. A proper surgical treatment in some cases of stomal recurrence would prolong the lifetime and advance the life quality of the patients.
探讨喉切除术后造口复发的有效防治方法。
对23例喉切除术后造口复发患者进行回顾性分析。23例患者中，20例由其他医院转诊至中国医学科学院肿瘤医院。分析该组喉切除术后造口复发的病因病理、各种手术治疗的可行性及临床处理结果。
喉癌声门下扩展、声门旁间隙侵犯及气管周围转移可能导致造口复发。18例行手术治疗患者的生存期长于5例未治疗或仅行放疗和/或化疗患者。1年和5年生存率分别为40.7%和20.4%。常见并发症为咽瘘。手术治疗可缓解局部疼痛、改善呼吸、恢复吞咽并减少癌性溃疡出血。
喉切除术后造口周围复发的总体预后较差。在手术治疗声门下扩展、声门旁间隙侵犯及气管周围淋巴结转移时应强调预防。对部分造口复发患者进行适当的手术治疗可延长患者生存期并提高生活质量。
