Tea B, Morel N, Chahine K, Sulaj H, Reyt E, Righini C A
CHU de Grenoble, Clinique ORL, Pôle tête et cou et Chirurgie réparatrice, 38043 Grenoble cedex 09, France.
Rev Laryngol Otol Rhinol (Bord). 2008;129(4-5):277-83.
This is a retrospective study conducted over a period of 10 years (1995-2005). Inclusion criteria included: 1) Squamous cell carcinoma of the vocal cords reaching the anterior commissure; 2) Absence of previous treatment for the glottic lesion; 3) Minimum follow-up period of 24 months. The functional results were evaluated according to duration of hospitalization, and the time elapsed before decanulation and realimentation. Statistical analysis was performed using the stat-view software.
Forty-one patients underwent partial supra-cricoid laryngectomy. All patients had a tumour stage I or II. Mean follow-up was of 88 months. Tumour resection was complete in 95% of cases. The rate of lymph node involvement was 7.3%. Four patients (9.8%) developed local recurrence 13 months, on average, postoperatively. Three patients (7.3%) developed a metachronous lesion 14 months, on average, postoperatively. Three patients (7.3%) died during the follow-up period (2 cases related to the cancer). The specific survival and recurrence-free survival rates were 95% and 84.7% respectively. There was no statistically significant difference in survival rates between patients with stage I and stage II tumours. The mean duration of hospitalization was 24 days. The mean time intervals to decanulation and realimentation were 21 and 15 days respectively.
Partial supra-cricoid laryngectomy with crico-hyoido-pexy is one surgical option in laryngeal conservative surgery. This surgical procedure allows for adequate oncological control and good functional results as long as the indications are well respected and the surgical techniques are well mastered.
1）分析对诊断为累及前联合的声门鳞状细胞癌患者，行环状软骨上部分喉切除术加环舌骨固定术作为主要治疗方式的肿瘤学及早期功能结果；2）提出治疗方案。
这是一项为期10年（1995 - 2005年）的回顾性研究。纳入标准包括：1）声带鳞状细胞癌累及前联合；2）声门病变此前未接受过治疗；3）最短随访期24个月。根据住院时间、拔管时间及恢复经口进食时间评估功能结果。使用Stat-View软件进行统计分析。
41例患者接受了环状软骨上部分喉切除术。所有患者肿瘤分期为I期或II期。平均随访88个月。95%的病例肿瘤切除完整。淋巴结受累率为7.3%。4例患者（9.8%）术后平均13个月出现局部复发。3例患者（7.3%）术后平均14个月出现异时性病变。3例患者（7.3%）在随访期内死亡（2例与癌症相关）。特异性生存率和无复发生存率分别为95%和84.7%。I期和II期肿瘤患者的生存率无统计学显著差异。平均住院时间为24天。拔管和恢复经口进食的平均时间分别为21天和15天。
环状软骨上部分喉切除术加环舌骨固定术是喉保留手术的一种手术选择。只要严格掌握适应证并熟练掌握手术技巧，该手术操作可实现充分的肿瘤学控制并取得良好的功能结果。
