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窗式喉部分切除术治疗 T2-3 期声门型喉癌的临床疗效。

Clinical outcome of window partial laryngectomy for stage T2-3 glottic laryngeal carcinoma.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Shantou City Central Hospital, Shantou, China.

出版信息

J Voice. 2011 Jan;25(1):124-8. doi: 10.1016/j.jvoice.2009.07.001. Epub 2010 Feb 19.

DOI:10.1016/j.jvoice.2009.07.001
PMID:20171837
Abstract

OBJECTIVE

To investigate the operative impact and therapeutic value of window partial laryngectomy for the treatment of stage T2-3 glottic laryngeal carcinoma.

METHODS

From October 2000 to December 2006, window partial laryngectomy and laryngeal reconstruction were performed on 48 appropriately selected patients with stage T2-3 glottic laryngeal carcinomas. Twenty-nine males and 19 females were included. Before the operation and in the sixth month after the operation, degree of hoarseness, vocal fold mobility and symmetry, glottal width during quiet breathing, degree of glottal closure during phonating, respiratory function, and swallowing function were surveyed. In addition, tumor recurrence and metastasis and patient survival time were monitored.

RESULTS

With the exception of vocal fold mobility (P=0.343), there were significant differences between the two treatment groups in all areas that were investigated, including degree of hoarseness (all P<0.01), vocal fold symmetry (P=0.000), glottal width during quiet breathing (P=0.001), degree of glottal closure during phonating (P=0.001), and respiratory function (P=0.001). Swallowing function was not influenced (P=0.310). There was recurrence in one case (2.1%), cervical lymph node metastasis in one case, and hepatic metastasis in one case. The 3- and 5-year overall survival rates were 96.9% and 88.9%, respectively.

CONCLUSIONS

This study showed that window partial laryngectomy was successful for treating properly selected stage T2-3 glottic laryngeal carcinoma. This operation was effective for reducing surgical invasion and facilitated the resumption of respiratory and vocal function.

摘要

目的

探讨窗式喉部分切除术治疗 T2-3 期声门型喉癌的手术效果和治疗价值。

方法

2000 年 10 月至 2006 年 12 月,对 48 例 T2-3 期声门型喉癌患者进行了窗式喉部分切除术和喉重建术。患者中男 29 例,女 19 例。术前及术后 6 个月,分别检测患者的嗓音嘶哑程度、声带活动度及对称性、安静呼吸时声带闭合程度、发声时声带闭合程度、呼吸功能和吞咽功能,并对肿瘤复发、转移及患者生存时间进行监测。

结果

除声带活动度(P=0.343)外,两组患者在嗓音嘶哑程度(均 P<0.01)、声带对称性(P=0.000)、安静呼吸时声带闭合程度(P=0.001)、发声时声带闭合程度(P=0.001)和呼吸功能(P=0.001)等方面差异均有统计学意义,而吞咽功能差异无统计学意义(P=0.310)。术后 1 例复发(2.1%),1 例发生颈淋巴结转移,1 例发生肝转移。3 年和 5 年总生存率分别为 96.9%和 88.9%。

结论

窗式喉部分切除术治疗 T2-3 期声门型喉癌效果满意,能有效减少手术创伤,有利于患者呼吸和发声功能的恢复。

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