Liu Fanli, He Xiaoguang, Li Yuxiao, Wang Fuke
Department of Otorhinolaryngology, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, 325000, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Aug;26(15):673-7.
To compare the results of supracricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) and horizontal-vertical hemilaryngectomy in the treatment of mid and late laryngeal carcinoma.
Retrospective analysis on the types of mid and late stage of laryngeal carcinoma clinical material, 22 patients supracricoid partial laryngectomy-cricohyoidopexy, 20 patients horizontal-vertical hemilaryngectomy, each with the added radiotherapy. The long term results of operation and glottic reconstruction were evaluated by postoperative visiting, semi-quantitative speech intelligibility analysis, electroglottograph (EGG) and so on.
Forty-two cases of laryngeal cancer patients were decannulated, the decannulation rate was 100%. Postoperative decannulation time: surgical CHP for (44.0 +/- 4.6) d, 3/4 throat operation for (39.0 +/- 2.7) d, two groups of postoperative decannulation time difference was statistically significant (t = 4.2395, P < 0.01). Eight weeks after evaluation, two groups's swallowing function and postoperative evaluation of patients after one year speech intelligibility difference was not statistically significant (P > 0.05). GRBAS in the evaluation of G rating, the difference between the two groups was statistically significant (P < 0.05), CHP group showed,for most patients, a severe hoarse degree, but 3/4 throat operation group mainly represented a moderate degree lever. EGG parameters were checked after 1 years. F0 comparative differences was not statistically significant (P > 0.05), and the jitter, shimmer and NNE compared CHP group to 3/4 laryngectomy group were significantly increased (P < 0.05). Kaplan-Meier method statistics show: CHP group and 3/4 laryngectomy group 3 years and 5 year accumulate survival rates were 95.5% and 89.7%, 85.1% and 83.7% respectively, two groups of three, five years of survival difference was not statistically significant (P > 0.05).
According to the laryngeal of middle-late carcinoma, the region and the involvement of the scope were considered to choose appropriate surgical treatments, and both can complete resection of the tumor, and can retain good laryngeal functions,and CHP has a wider range of operation indications and clinical application prospect, is worthy to be popularized.
比较环状软骨上部分喉切除术-环舌骨固定术（SCPL-CHP）与水平垂直半喉切除术治疗中晚期喉癌的效果。
回顾性分析中晚期喉癌临床资料类型，22例行环状软骨上部分喉切除术-环舌骨固定术，20例行水平垂直半喉切除术，均加行放疗。通过术后随访、半定量言语清晰度分析、电子喉镜（EGG）等评估手术及声门重建的远期效果。
42例喉癌患者均拔管，拔管率为100%。术后拔管时间：SCPL-CHP手术为（44.0±4.6）天，3/4喉手术为（39.0±2.7）天，两组术后拔管时间差异有统计学意义（t = 4.2395，P < 0.01）。评估8周后，两组吞咽功能及术后1年患者言语清晰度评估差异无统计学意义（P > 0.05）。GRBAS评估中G分级，两组差异有统计学意义（P < 0.05），SCPL-CHP组多数患者表现为重度声嘶，而3/4喉手术组主要表现为中度声嘶程度。术后1年检查EGG参数。F0比较差异无统计学意义（P > 0.05），而SCPL-CHP组与3/4喉切除术组相比，微扰、振幅微扰和噪声能量显著增加（P < 0.05）。Kaplan-Meier法统计显示：SCPL-CHP组与3/4喉切除术组3年和5年累积生存率分别为95.5%和89.7%，85.1%和83.7%，两组3、5年生存率差异无统计学意义（P > 0.05）。
根据中晚期喉癌的部位及累及范围选择合适的手术方式，两者均能完整切除肿瘤，且能保留较好的喉功能，SCPL-CHP手术适应证范围更广，具有临床应用前景，值得推广。
