【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。手術切除病變組織后行喉成形,同時行雙側選擇性頸清掃術。術后3例患者未接受放化療,其余11例均行放化療。術后隨訪6個月~5年,平均3年6個月。結果:12例患者切口一期愈合,2例咽瘺經換藥后痊愈。患者均有術后吞咽嗆咳,最遲術后2個月拔胃管經口進食。11例術后放化療者中10例隨訪3年未見復發(fā),1例復發(fā)未治療后死亡。3例未接受放化療者中,2例在6個月內復發(fā),行放化療后1例未見復發(fā),1例失訪;1例術后8個月復發(fā),行全喉切除術,術后放化療,首次術后1年6個月死亡。3年生存率為78.6%;患側聲帶6例有輕微動度,8例無明顯聲帶解剖標志。結論:選擇適當病例,對累及聲門旁間隙的梨狀窩癌患者行喉功能保存手術,可取得較好的臨床效果,使患者有更好的生存質量。
[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】： 四川大學華西醫(yī)院耳鼻咽喉-頭頸外科;
【分類號】：R739.6

【參考文獻】

相關期刊論文 前6條

1 李文;楊柳;陳哲;秦偉;史麗英;;會厭癌手術治療中的個體化喉部分切除術[J];臨床耳鼻咽喉頭頸外科雜志;2012年24期

2 王曉雷,屠規(guī)益,唐平章;喉功能保留的梨狀窩癌外科治療[J];中華耳鼻咽喉科雜志;2000年04期

3 李學忠,張立強,潘新良,解光,欒信庸,王天鐸;保留喉功能的梨狀窩癌的手術治療[J];中華耳鼻咽喉頭頸外科雜志;2005年03期

4 王建宏,祁永發(fā),唐平章,徐震綱,溫樹信,劉明波;梨狀窩癌手術前后放療與喉功能保全[J];中華耳鼻咽喉頭頸外科雜志;2005年07期

5 楊懷安 ,林隆一 ,海老原 敏;梨狀窩癌對側頸淋巴轉移的臨床特點[J];中華耳鼻咽喉頭頸外科雜志;2005年07期

6 賞金標,王可敬,許亞萍,郭良,葛明華;梨狀窩癌的治療和生存分析[J];中華耳鼻咽喉頭頸外科雜志;2005年08期

【共引文獻】

相關期刊論文 前10條

1 康冰飛;隋秀芳;;甲狀旁腺病變的超聲表現和誤診分析[J];安徽醫(yī)學;2012年04期

2 張詮,郭朱明,傅劍華,曾宗淵,陳福進,魏茂文,伍國號,楊安奎;胸骨劈開進路甲狀腺癌上縱隔淋巴結清掃術12例臨床應用[J];癌癥;2004年07期

3 陳福進,李秋梨,曾宗淵,宋明,楊安奎,張詮;分化型甲狀腺癌的治療及影響復發(fā)的因素分析[J];癌癥;2004年11期

4 郭桂芳,楊安奎,謝汝華,陳直華,吳秋良,區(qū)深明,劉巍巍,夏良平,陳明遠,張晉昕,吳劍輝;151例上頜竇惡性腫瘤的預后因素分析[J];癌癥;2004年S1期

5 張道宮,欒信庸,潘新良,解光;老年下咽癌患者的手術治療與喉功能保留[J];癌癥;2005年11期

6 吳延升;王旭東;張文超;戰(zhàn)忠利;張侖;;甲狀腺濾泡狀腺癌手術術式探討[J];癌癥;2008年02期

7 馬士],詹曉東,徐淑秀,祖志將,蔣成義;梨狀窩癌的喉功能保留手術[J];蚌埠醫(yī)學院學報;2003年05期

8 陳s，

本文編號：2156791