咽侧径路水平喉部分切除术19例报告

发布时间：2019-02-15 20:32

【摘要】：目的:探讨咽侧径路水平喉部分切除手术的技术操作、疗效及该径路积极的临床意义。方法:收集2000-2008年间咽侧径路水平喉部分切除术19例患者的临床资料,11例声门上型,8例下咽上型(其中1例侵犯舌体,2例侵犯舌根扁桃体软腭,2例侵犯下咽侧后壁);其中术中采用直接缝合12例,甲状软骨膜3例,胸锁乳突肌肌皮瓣1例,胸大肌肌肌皮瓣修复3例。术后根据需要给予放射治疗。结果:19例患者全部拔出气管套管,16例一期拔管,拔管后呼吸通畅;发声良好,无1例发生咽瘘;1例术后6个月仍有轻度误吸,1例术后1年突然咽部大出血死亡,2例术后颈总动脉转移出血死亡,4例术后2年内复发,3例3~5年内复发;3年生存率78.9%,5年生存率57.9%。结论:咽侧径路水平喉部分切除术损伤相对小,功能恢复快,为较好的手术方式。
[Abstract]:Objective: to investigate the technique and effect of horizontal partial laryngectomy via lateral pharyngeal approach and its positive clinical significance. Methods: the clinical data of 19 patients undergoing horizontal partial laryngectomy with lateral pharyngeal approach from 2000 to 2008 were collected. There were 11 cases of supraglottic type and 8 cases of suprapharyngeal type (1 case invaded the tongue body, 2 cases invaded the tonsil soft palate of tongue root). 2 cases invaded the posterior wall of hypopharynx. There were 12 cases with direct suture, 3 cases with thyroid chondroid membrane, 1 case with sternocleidomastoid myocutaneous flap and 3 cases with pectoralis major myocutaneous flap. Radiotherapy was given as needed after the operation. Results: the tracheal cannula was pulled out in all of the 19 cases, 16 cases were extubated in one stage, the breath was smooth after extubation, the vocal sound was good, and no pharyngeal fistula occurred in 1 case. One case still had slight aspiration 6 months after operation, 1 case died of sudden pharyngeal hemorrhage 1 year after operation, 2 cases died of common carotid artery metastasis bleeding, 4 cases recurred within 2 years after operation, 3 cases recurred within 3 ~ 5 years. The 3-year survival rate was 78. 9%, and the 5-year survival rate was 57. 9%. Conclusion: horizontal partial laryngectomy via the lateral pharyngeal approach is a better method with relatively small injury and rapid functional recovery.
【作者单位】：苏州大学附属第一医院耳鼻咽喉科;
【分类号】：R739.65

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