Lau W F, Wei W I, Ho C M, Lam K H
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Am J Surg. 1988 Oct;156(4):269-72. doi: 10.1016/s0002-9610(88)80289-7.
A 2-year prospective study on primary tracheoesophageal puncture was carried out to evaluate the morbidity of the procedure and its success in restoring speech. Fifty-two patients, 36 of whom suffered from carcinoma of the larynx and 16, carcinoma of the hypopharynx, were entered into the study. Thirty-three patients underwent total laryngectomy with primary pharyngeal closure, 14 patients had, in addition, pharyngectomy and pectoralis major myocutaneous flap reconstruction, and 5 patients had pharyngolaryngoesophagectomy and gastric transposition. Tracheoesophageal or tracheogastric speech was successful in 58, 86, and 80 percent, respectively. Manometric studies showed that the neopharyngeal sphincter pressure decreased in all instances, but a correlation between the neopharyngeal pressure and the success of tracheoesophageal speech was not demonstrable. The morbidity rate related to tracheoesophageal puncture was low. Therefore, we believe it to be a safe and feasible procedure that can facilitate early voice restoration.
开展了一项关于一期气管食管穿刺的为期2年的前瞻性研究，以评估该手术的发病率及其恢复言语功能的成功率。52例患者纳入本研究，其中36例患有喉癌，16例患有下咽癌。33例患者接受了全喉切除术并一期缝合咽部，14例患者还接受了咽切除术及胸大肌肌皮瓣重建术，5例患者接受了咽-喉-食管切除术及胃移位术。气管食管发音或气管胃发音的成功率分别为58%、86%和80%。压力测量研究表明，所有病例的新咽部括约肌压力均降低，但新咽部压力与气管食管发音成功率之间无明显相关性。气管食管穿刺的发病率较低。因此，我们认为这是一种安全可行的手术，可促进早期言语恢复。
