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环状软骨上喉部分切除术:肿瘤学和功能结果分析。

Supracricoid partial laryngectomy: analyses of oncologic and functional outcomes.

机构信息

Otorhinolaryngology Department, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.

出版信息

Otolaryngol Head Neck Surg. 2012 Dec;147(6):1093-8. doi: 10.1177/0194599812457334. Epub 2012 Aug 11.

Abstract

OBJECTIVE

The aim of this study was to analyze the functional and oncologic results of supracricoid partial laryngectomy.

STUDY DESIGN

Case series with chart review.

SETTING

Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.

SUBJECT AND METHODS

The medical records of 56 patients, who underwent supracricoid partial laryngectomy between March 2002 and December 2010, were reviewed in this study. Forty-three patients underwent supracricoid partial laryngectomy with cricohyoidopexy, and 13 patients underwent cricohyoidoepiglottopexy. The overall and disease-specific survival, local control rates, and the mean time of decannulation and nasogastric tube removal were evaluated. Association of type of surgery with the functional and oncologic outcomes was evaluated and statistically compared.

RESULTS

The median follow-up period was 58 months. The 1-, 3-, and 5-year overall survival rates were 100%, 96.4%, and 82.1%, respectively. The 1-, 3-, and 5-year local control rates were 100%, 96.1%, and 92.5%, respectively. Type of surgery did not show any significant difference in survival and local control rates (P = .546, P = .455). The mean (SD) decannulation and nasogastric feeding tube removal time was 11.43 (2.03) and 16.79 (3.51) days, respectively. The mean time of decannulation and nasogastric tube removal was significantly longer in patients who underwent cricohyoidopexy when compared with those who underwent cricohyoidoepiglottopexy (P = .002, P = .000).

CONCLUSION

Although delaying deglutition functions could be termed a disadvantage of supracricoid laryngectomy, especially with cricohyoidopexy, supracricoid laryngectomy has reliable oncologic and functional results for locally advanced laryngeal cancers while maintaining laryngeal functions.

摘要

目的

本研究旨在分析环状软骨上喉部分切除术的功能和肿瘤学结果。

研究设计

病例系列,回顾性研究。

设置

土耳其伊兹密尔卡提普切莱比大学阿塔图尔克培训与研究医院。

研究对象和方法

本研究回顾了 2002 年 3 月至 2010 年 12 月期间 56 例接受环状软骨上喉部分切除术的患者的病历。43 例患者接受环状软骨舌骨固定术,13 例患者接受环状软骨会厌固定术。评估总生存率、疾病特异性生存率、局部控制率以及拔管和鼻饲管拔除的平均时间。评估手术类型与功能和肿瘤学结果的关系,并进行统计学比较。

结果

中位随访时间为 58 个月。1、3、5 年总生存率分别为 100%、96.4%和 82.1%。1、3、5 年局部控制率分别为 100%、96.1%和 92.5%。手术类型在生存率和局部控制率方面无显著差异(P =.546,P =.455)。拔管和鼻饲管拔除的平均(SD)时间分别为 11.43(2.03)和 16.79(3.51)天。与行环状软骨会厌固定术的患者相比,行环状软骨舌骨固定术的患者拔管和鼻饲管拔除的时间明显更长(P =.002,P =.000)。

结论

虽然环状软骨上喉部分切除术尤其是行环状软骨舌骨固定术会延迟吞咽功能,但对于局部晚期喉癌,它具有可靠的肿瘤学和功能结果,同时保留了喉功能。

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