累及声门旁间隙的梨状窝癌喉功能保存手术

李文; 易雪莲; 杨柳; 秦伟; 陈敏

doi:10.13201/j.issn.1001-1781.2014.09.005

累及声门旁间隙的梨状窝癌喉功能保存手术

- 四川大学华西医院耳鼻咽喉-头颈外科(成都, 610041)

详细信息

通讯作者: 李文, E-mail:church.ent.wc@163.com

中图分类号: R739.6

收稿日期: 2013-10-23

Laryngeal function preservated surgery for piriform sinus carcinoma with paraglottic space involvement

- Department of Otolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China

More Information

Corresponding author: LI Wen, E-mail: church.ent.wc@163.com

Received Date: 23 October 2013

摘要

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。
- 下咽癌 /
- 梨状窝 /
- 喉功能保存 /
- 手术
Abstract: Objective:To investigate the feasibility and results of laryngeal functional preservation surgery for piriform sinus carcinoma with paraglottic space involvement. Method:Fourteen cases of piriform sinus carcinoma with paraglottic space involvement were reviewed. Laryngoplasty was performed after tumor was resected, bilateral selective neck dissections were performed at the same stage. Postoperative chemoradiotherapy was applied to 11 patients while the other 3 patients did not receive chemotherapy nor radiotherapy.The follow-up time ranged from 6 months to 5 years, and the mean follow-up time was three and a half years. Result:Twelve cases healed primarily while 2 cases experienced delayed heal because of pharyngeal fistula. Postoperative swallow bucking occurred in all patients, the longest gastric feeding time was 2 months. For the patients underwent postoperative chemoradiotherapy, the tumor did not recur in ten cases during the 3 years follow-up, while recurred in another case and the patient died without further treatment. Among those 3 cases without postoperative radiotherapy or chemotherapy, the tumor recurred in 2 cases during the following 6 months and chemoradiotherapy was applied, no recurrence presented in one patient, another one lost of follow-up.For the patient with recurred tumor 8 months after surgery,total laryngectomy was employed with postoperative chemoradiotherapy, the case died of tumor recurrence one and half year after the first surgery. The 3-year survival rate was 78.6%. For the vocal cord at lesion side, the mobility was noticeable in 6 patients, and visible anatomic landmark was lost in the other 8 patients. Conclusion:Laryngeal function preservated surgery could be performed in selected cases of piriform sinus carcinoma with paraglottic space involvement in order to achieve better clinical results and quality of life.
- hypopharyngeal carcinoma /
- piriform sinus /
- laryngeal functional preservation /
- surgery

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