發(fā)布時(shí)間：2018-07-31 20:52

【摘要】：目的:探討累及聲門旁間隙的梨狀窩癌喉功能保存手術(shù)的可行性和治療效果。方法:回顧性分析14例累及聲門旁間隙梨狀窩癌患者的臨床資料。手術(shù)切除病變組織后行喉成形,同時(shí)行雙側(cè)選擇性頸清掃術(shù)。術(shù)后3例患者未接受放化療,其余11例均行放化療。術(shù)后隨訪6個(gè)月~5年,平均3年6個(gè)月。結(jié)果:12例患者切口一期愈合,2例咽瘺經(jīng)換藥后痊愈�；颊呔行g(shù)后吞咽嗆咳,最遲術(shù)后2個(gè)月拔胃管經(jīng)口進(jìn)食。11例術(shù)后放化療者中10例隨訪3年未見復(fù)發(fā),1例復(fù)發(fā)未治療后死亡。3例未接受放化療者中,2例在6個(gè)月內(nèi)復(fù)發(fā),行放化療后1例未見復(fù)發(fā),1例失訪;1例術(shù)后8個(gè)月復(fù)發(fā),行全喉切除術(shù),術(shù)后放化療,首次術(shù)后1年6個(gè)月死亡。3年生存率為78.6%;患側(cè)聲帶6例有輕微動(dòng)度,8例無明顯聲帶解剖標(biāo)志。結(jié)論:選擇適當(dāng)病例,對累及聲門旁間隙的梨狀窩癌患者行喉功能保存手術(shù),可取得較好的臨床效果,使患者有更好的生存質(zhì)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.
【作者單位】： 四川大學(xué)華西醫(yī)院耳鼻咽喉-頭頸外科;
【分類號】：R739.6

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本文編號：2156791