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一种用于无游离皮瓣重建的晚期舌/舌根癌的替代手术技术。

An alternative surgical technique for advanced tongue/tongue base cancer without free flap reconstruction.

机构信息

Department of Otolaryngology, Lotung Pohai Hospital, Yilan, Taiwan.

Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.

出版信息

J Formos Med Assoc. 2022 Dec;121(12):2626-2632. doi: 10.1016/j.jfma.2022.07.007. Epub 2022 Aug 16.

Abstract

BACKGROUND/PURPOSE: Locally advanced tongue or tongue base cancer is recommended to be treated by radical resection that is usually detrimental to physiological functions. This study reports the efficacy and treatment outcome of the patients who had received total glossectomy and laryngeal suspension without lip-split mandibulotomy and free flap reconstruction to preserve laryngopharyngeal function.

METHODS

From 2010 to 2018, 37 consecutive patients who had received the surgery were retrospectively recruited.

RESULTS

The overall five-year survival is 72%. The postoperative dependent rate of feeding tube and tracheostomy largely decreases within 1-year follow-up. Treated by this surgical method, these patients are free from facial disfiguration, donor site morbidity, and destructive mastication and occlusion. It is also feasible to perform this surgical technique in the recurrent cases previously treated by chemoradiation.

CONCLUSION

Total glossectomy with laryngeal suspension can be successfully applied to locally advanced tongue or tongue base cancer, and benefits the patients with improved survival and preserved physiological function. Especially surgeons for free flap reconstruction are understaffed at some regional or district hospitals.

摘要

背景/目的:局部晚期舌或舌根癌推荐采用根治性切除术,但该术式通常对生理功能有害。本研究报告了 37 例接受全舌切除术和喉悬吊术(无需唇裂下颌骨切开术和游离皮瓣重建)以保留咽喉功能的患者的疗效和治疗结果。

方法

2010 年至 2018 年,回顾性招募了 37 例连续接受该手术的患者。

结果

总的五年生存率为 72%。术后依赖饲管和气管切开的比率在 1 年随访内显著降低。采用该手术方法,患者无面部畸形、供区并发症、咀嚼和咬合功能破坏。对于先前接受放化疗治疗的复发患者,也可以实施该手术技术。

结论

全舌切除术联合喉悬吊术可成功应用于局部晚期舌或舌根癌,可改善患者的生存,并保留生理功能。特别是在一些地区或区级医院,游离皮瓣重建术的外科医生人手不足。

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