Gehanno P, Guedon C, Baujat B, Depondt J, Barry B
Service de chirurgie cervicomaxillo-faciale, groupe hospitalier Bichat-Claude-Bernard, Paris, France.
Bull Cancer Radiother. 1996;83(2):118-20.
Because local control of locally advanced cancer of base of tongue and larynx managed with combined chemotherapy and radiotherapy is poor, we proposed total glossectomy with total laryngectomy. Twenty-one patients underwent this operation over a period of 8 years. It was a salvage surgery for 15 patients, and an up-front surgery for the 6 others. Postoperative complications occurred in ten patients, and three patients died in the postoperative period. Mean total duration of hospitalisation was 40 days. Oral feeding could be achieved in 14 patients (mean delay: 46 days), but satisfactory oesophageal voice has never been obtained. We can conclude from the analysis of this series that total glossectomy with total laryngectomy is a heavy surgery, which leads to frequent complications, severe functional sequellae, and poor survival. However, control of pain can be obtained, that justifying this heavy procedure. We recommend that patients and relatives should be fully informed about the consequences of surgery before final decision.
由于采用化疗和放疗联合治疗的局部晚期舌根癌和喉癌的局部控制效果不佳，我们提出了全舌切除术加全喉切除术。在8年的时间里，有21名患者接受了该手术。其中15例为挽救性手术，另外6例为前期手术。10例患者出现术后并发症，3例患者在术后死亡。平均总住院时间为40天。14例患者能够实现经口进食（平均延迟时间：46天），但从未获得满意的食管发音。通过对该系列病例的分析，我们可以得出结论，全舌切除术加全喉切除术是一项重大手术，会导致频繁的并发症、严重的功能后遗症和较差的生存率。然而，可以实现疼痛控制，这证明了这种重大手术的合理性。我们建议在做出最终决定之前，应让患者及其亲属充分了解手术的后果。
