Başaran Bora, Doruk Can, Aydemir Levent
Department of Otolaryngology & Head and Neck Surgery, İstanbul University School of Medicine, İstanbul, Turkey.
Turk Arch Otorhinolaryngol. 2020 Sep;58(3):193-196. doi: 10.5152/tao.2020.5079. Epub 2020 Sep 1.
Supratracheal laryngectomy (STL) is the ultimate option in conservation surgery, and can be used as an alternative to total laryngectomy in selected tumors. This case series is the first report from Turkey that analyzes the oncological and functional outcomes of STL along with a literature review. Files of five patients who underwent STL between June 2016 and June 2019 were analyzed. Primary tumor findings, postoperative pathology reports, treatment modalities and oncological and functional outcomes of the surgical intervention were noted. Two patients were operated on for horse-shoe glottic tumors with subglottic extension, one patient for primary subglottic mass and two for transglottic ventricular tumors with anterior subglottic extension. Pathological stage of two patients was T3, and of three patients was T4a due to thyroid cartilage invasion. No neck metastases were observed. Three patients with T4a primary tumor were treated with adjuvant radiotherapy. All patients were found disease free in their last follow-up visit. Nasogastric tube was removed in the 1 postoperative month in all patients. While one patient remained tracheostomized in the follow-up period, the remaining four were decannulated. This technique can be used as an alternative to total laryngectomy especially in selected cases with subglottic extension.
气管上喉切除术(STL)是保留手术的最终选择,可作为特定肿瘤全喉切除术的替代方案。本病例系列是土耳其的首份报告,分析了STL的肿瘤学和功能结果,并进行了文献综述。分析了2016年6月至2019年6月期间接受STL的5例患者的病历。记录了原发肿瘤的发现、术后病理报告、治疗方式以及手术干预的肿瘤学和功能结果。2例患者因马蹄形声门肿瘤伴声门下扩展接受手术,1例患者因原发性声门下肿物接受手术,2例患者因跨声门室带肿瘤伴声门下前部扩展接受手术。2例患者的病理分期为T3,3例患者因甲状腺软骨侵犯病理分期为T4a。未观察到颈部转移。3例T4a期原发性肿瘤患者接受了辅助放疗。所有患者在最后一次随访时均未发现疾病。所有患者术后1个月均拔除鼻胃管。随访期间,1例患者仍需气管切开,其余4例患者拔管。该技术尤其可作为声门下扩展的特定病例全喉切除术的替代方案。