累及声门旁间隙的梨状窝癌喉功能保存手术

发布时间：2018-07-31 20:52

【摘要】：目的:探讨累及声门旁间隙的梨状窝癌喉功能保存手术的可行性和治疗效果。方法:回顾性分析14例累及声门旁间隙梨状窝癌患者的临床资料。手术切除病变组织后行喉成形,同时行双侧选择性颈清扫术。术后3例患者未接受放化疗,其余11例均行放化疗。术后随访6个月~5年,平均3年6个月。结果:12例患者切口一期愈合,2例咽瘘经换药后痊愈。患者均有术后吞咽呛咳,最迟术后2个月拔胃管经口进食。11例术后放化疗者中10例随访3年未见复发,1例复发未治疗后死亡。3例未接受放化疗者中,2例在6个月内复发,行放化疗后1例未见复发,1例失访;1例术后8个月复发,行全喉切除术,术后放化疗,首次术后1年6个月死亡。3年生存率为78.6%;患侧声带6例有轻微动度,8例无明显声带解剖标志。结论:选择适当病例,对累及声门旁间隙的梨状窝癌患者行喉功能保存手术,可取得较好的临床效果,使患者有更好的生存质量。
[Abstract]:Objective: to investigate the feasibility and therapeutic effect of laryngeal function preservation surgery for Pyriform fossa carcinoma involving the paraventricular space. Methods: the clinical data of 14 patients with Pyriform fossa carcinoma involved in the paraventral space were retrospectively analyzed. Laryngoplasty and bilateral selective neck dissection were performed after resection of diseased tissues. Three patients did not receive radiotherapy and chemotherapy, the other 11 patients received radiotherapy and chemotherapy. Postoperative follow-up ranged from 6 months to 5 years, with an average of 3 years and 6 months. Results two cases of pharyngeal fistula were cured after dressing change. All patients had postoperative dysphagia and cough. Of the 11 patients with postoperative radiotherapy and chemotherapy, 10 patients had no recurrence after 3 years of follow-up, and 2 out of 3 patients who died without chemotherapy and radiotherapy received radiotherapy and chemotherapy within 6 months, 2 out of 10 patients with postoperative chemotherapy and radiotherapy were followed up for 3 years, and 2 of them had relapsed within 6 months. After radiotherapy and chemotherapy, 1 case had no recurrence and 1 case had recurrence 8 months after operation, underwent total laryngectomy, postoperative chemotherapy and radiotherapy. The 3-year survival rate was 78.6%, and the slight movement of vocal cord was found in 8 cases without obvious vocal cord anatomic markers. Conclusion: to select appropriate cases and perform laryngeal function preservation in patients with Pyriform fossa carcinoma involving the paraventricular space can obtain better clinical effect and make patients have better quality of life.
【作者单位】：四川大学华西医院耳鼻咽喉-头颈外科;
【分类号】：R739.6

【参考文献】