摘要
背景与目的:喉癌尤其是声门上癌手术往往涉及对舌根的处理,以往对累及舌根的晚期喉癌行舌根大部切除后,缺乏简单有效的舌根修复方法,因而许多患者的喉功能恢复不理想。此外,以舌根瓣来重建喉功能以往报道亦较少。本文探讨喉癌手术治疗中对舌根的处理方法,以期提供一种简便可靠的喉功能重建的术式。方法:切除喉部肿瘤或被累及的舌根后,根据组织缺损的情况,以胸骨舌骨肌筋膜瓣成形舌根;舌根保留较多时以舌根下移来重建喉功能。结果:32例喉部分切除术中,26例拔管,拔管率为81.3%,患者均恢复满意的发音功能;4例全喉切除术未行发音重建。无误咽、呛咳发生。3年生存率为81.3%,5年生存率为65.6%。结论:舌根成形与舌根下移能恢复满意的喉功能,操作简单、创伤较小、并发症少,是喉癌治疗中较为理想的手术方式。
BACKGROUND &OBJECTIVE: The surgical treatment of laryngeal cancer, especially for the supraglottic cancer, usually involve the management of tongu e-base, which is important in the rebuilding laryngeal function. There was no s imple and effective method to repair tongue-base previously, which was removed for the greater part when invaded by advanced laryngeal cancer. As a result, man y cases could not regain the satisfactory laryngeal function. And only several p ublished reports focused on the efficacy of rebuilding laryngeal function by mea ns of tongue-base flap. In order to develop a simple and reliable method to reb uild the laryngeal function, the management of tongue base in surgical treatment of laryngeal cancer was explored. METHODS: After the laryngeal carcinoma or the involved tongue-base was removed, according to the extent of surgical defect, sternohyoid myofascial flap was used to reconstruct the tongue-base, or the ton gue-base was selected to rebuild the laryngeal function when greater part of it was preserved. RESULTS: Out of the 32 cases with partial laryngectomy, 26 cases were decannulated with a decannulation rate of 81.3%, all the cases regained s peaking functions except 4 cases undergone total laryngectomy. All the cases res umed normal diet, none presented complication of accidental aspiration. The 3-y ear and 5-year survival rates were 81.3%and 65.6%, respectively. CONCLUSION: Reconstructing or pulling down the tongue-base is highly effective in rebuildin g satisfactory laryngeal function, which is easily and simply performed with les s damage and complications, appropriates for surgical treatment of laryngeal can cer.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2004年第6期678-681,共4页
Chinese Journal of Cancer
