喉部分切除双蒂双肌瓣修复术远期疗效分析
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摘要
目的 评价喉部分切除双蒂双肌瓣修复术的远期疗效。
方法 对我科1993年1月—1996年1月间喉部分切除双蒂双肌瓣修复的111例喉鳞癌病人进行随访及疗效分析。其中，声门上水平部分喉切除54例，垂直部分喉切除44例，3/4部分喉切除13例。
结果 总的3年、5年生存率分别为86.5%、76.6%，复发率12.6%, 术后发音功能良好，88例于1—4周内恢复吞咽功能，气管套管拔除率91.0%。
结论 喉部分切除双蒂双肌瓣修复术在保证生存率的同时，有效地保留了喉功能，提高了生存质量，是一种较好的修复方法。
Objective To evaluate the long term results of partial laryngectomy reconstructed with Bipeduncle and Bimuscle flap (BP-BMF) in the treatment of laryngeal cancers.
Methods A series of 111 cases treated by partial laryngectomy repaired with BP-BMF, between January 1993 and January 1996 ,were analysed, of whom 54 were supraglottic horizontal partial laryngectomy, 44 were vertical partial laryngectomy, and 13 were horizontal-vertical partial laryngectomy.
Results The 3 years and 5 years total survival rates were 86.5% and 76.6% respectively. The local recurrent rate was 12.6% during the period of 5 years follow-up. Most of the cases acquired good speech, and recovered their swallow function within 1—4 weeks. Decannulation rate was 91.0%.
Conclusion This procedure increased survival rate , in the meanwhile, it preserved laryngeal physiologic function, and improved life quality. So it is a ideal surgical technology, and is worthy to be recommended for partial laryngecotomy.
方法 对我科1993年1月—1996年1月间喉部分切除双蒂双肌瓣修复的111例喉鳞癌病人进行随访及疗效分析。其中，声门上水平部分喉切除54例，垂直部分喉切除44例，3/4部分喉切除13例。
结果 总的3年、5年生存率分别为86.5%、76.6%，复发率12.6%, 术后发音功能良好，88例于1—4周内恢复吞咽功能，气管套管拔除率91.0%。
结论 喉部分切除双蒂双肌瓣修复术在保证生存率的同时，有效地保留了喉功能，提高了生存质量，是一种较好的修复方法。
Objective To evaluate the long term results of partial laryngectomy reconstructed with Bipeduncle and Bimuscle flap (BP-BMF) in the treatment of laryngeal cancers.
Methods A series of 111 cases treated by partial laryngectomy repaired with BP-BMF, between January 1993 and January 1996 ,were analysed, of whom 54 were supraglottic horizontal partial laryngectomy, 44 were vertical partial laryngectomy, and 13 were horizontal-vertical partial laryngectomy.
Results The 3 years and 5 years total survival rates were 86.5% and 76.6% respectively. The local recurrent rate was 12.6% during the period of 5 years follow-up. Most of the cases acquired good speech, and recovered their swallow function within 1—4 weeks. Decannulation rate was 91.0%.
Conclusion This procedure increased survival rate , in the meanwhile, it preserved laryngeal physiologic function, and improved life quality. So it is a ideal surgical technology, and is worthy to be recommended for partial laryngecotomy.
引文
[1] 武乃旺，刘建伟，康秀水. 双蒂双肌瓣喉功能重建法. 中华耳鼻咽喉科杂志，1996；31(3)：178-180.
[2] 高太虎，崔雨田，段东升. 喉癌声门型T3的功能保全手术. 中华耳鼻咽喉科杂志，1999；34（6）：331-332.
[3] 武乃旺, 吴雨雷，张丁香. 双蒂双肌瓣在T3和T4喉癌扩大喉部分切除术中的应用. 中华耳鼻咽喉科杂志，2003; 38(4): 289-291.
[4] 胡俊兰，宋军健，曷俊恒，等.声门型喉癌T3病变喉部分切除术后疗效评价. 中华耳鼻咽喉科杂志，2000，35(3)：138-140.
[5] 赵瑞力，胡俊兰，曷俊恒，等. 喉额-侧切除术的临床应用. 中华耳鼻咽喉科杂志，2003；38(1)：7-9.
[6] 费声重，时曜唏，王尔莉，等. 278例喉部分切除术生存分析. 中华耳鼻咽喉科杂志，1986，21(5)：281-283.
[7] Giovanni A ,Guelfucci B,Gras R et al . Partial Frontolateral Laryngectomy With Epiglottic Reconstruction for Management of Early-Stage Glottic Carcinoma. Laryngoscope. 2001, 111(4) : 663-668
[8] Mallet Y， Chevalier D， Darras JA , et al. Near total laryngectomy with epiglottic reconstruction. our experience of 65 cases. Eur-Arch-Otorhinolaryngol. 2001; 258(9): 488-91
[9] Eliachar I, Papay F, Tucker HM . Laryngotracheal reconstruction ,extended vertical laryngectomy : reconstruction combing epiglottoplasty and the rotary door flap. Otolaryngol Clin North Am, 1991,24(6):1367
[10] 于峰，董玉礼，韩跃峰，等. 喉环上部分切除喉腔成形术. 中华耳鼻咽喉科杂志，2001；36(4)：213-215.
[11] 李宝江，徐树遗，李大军，等. 环上喉切除喉功能重建术78例疗效分析. 中华耳鼻咽喉科杂志，2001；36(4)：258-260.
[12] Adamopoulos G; Yiotakis J; Stavroulaki P; et al. Modified supracricoid partial laryngectomy with cricohyoidopexy: series report and analysis of results. Otolaryngol-Head-Neck-Surg. 2000 ; 123(3): 288-293
[13] Bron L , Brossard E ，Monnier P，et al。.Supracricoid Partial Laryngectomy With Cricohyoidoepiglottopexy and cricohyoidopexy for Glottic and Supraglottic Carcinomas .Laryngoscope, 2000；110：627-634
[14] 王斌全, 夏树信, 皇甫辉，等. 晚期喉癌切缘组织流式细胞仪参数及
PCNA表达的研究. 耳鼻咽喉-头颈外科，2003；10（3）：163-167.
[15] 王运钟. 喉癌手术切缘的研究. 国外医学耳鼻咽喉科学分册，1993；17（1）：13-16.
[2] 高太虎，崔雨田，段东升. 喉癌声门型T3的功能保全手术. 中华耳鼻咽喉科杂志，1999；34（6）：331-332.
[3] 武乃旺, 吴雨雷，张丁香. 双蒂双肌瓣在T3和T4喉癌扩大喉部分切除术中的应用. 中华耳鼻咽喉科杂志，2003; 38(4): 289-291.
[4] 胡俊兰，宋军健，曷俊恒，等.声门型喉癌T3病变喉部分切除术后疗效评价. 中华耳鼻咽喉科杂志，2000，35(3)：138-140.
[5] 赵瑞力，胡俊兰，曷俊恒，等. 喉额-侧切除术的临床应用. 中华耳鼻咽喉科杂志，2003；38(1)：7-9.
[6] 费声重，时曜唏，王尔莉，等. 278例喉部分切除术生存分析. 中华耳鼻咽喉科杂志，1986，21(5)：281-283.
[7] Giovanni A ,Guelfucci B,Gras R et al . Partial Frontolateral Laryngectomy With Epiglottic Reconstruction for Management of Early-Stage Glottic Carcinoma. Laryngoscope. 2001, 111(4) : 663-668
[8] Mallet Y， Chevalier D， Darras JA , et al. Near total laryngectomy with epiglottic reconstruction. our experience of 65 cases. Eur-Arch-Otorhinolaryngol. 2001; 258(9): 488-91
[9] Eliachar I, Papay F, Tucker HM . Laryngotracheal reconstruction ,extended vertical laryngectomy : reconstruction combing epiglottoplasty and the rotary door flap. Otolaryngol Clin North Am, 1991,24(6):1367
[10] 于峰，董玉礼，韩跃峰，等. 喉环上部分切除喉腔成形术. 中华耳鼻咽喉科杂志，2001；36(4)：213-215.
[11] 李宝江，徐树遗，李大军，等. 环上喉切除喉功能重建术78例疗效分析. 中华耳鼻咽喉科杂志，2001；36(4)：258-260.
[12] Adamopoulos G; Yiotakis J; Stavroulaki P; et al. Modified supracricoid partial laryngectomy with cricohyoidopexy: series report and analysis of results. Otolaryngol-Head-Neck-Surg. 2000 ; 123(3): 288-293
[13] Bron L , Brossard E ，Monnier P，et al。.Supracricoid Partial Laryngectomy With Cricohyoidoepiglottopexy and cricohyoidopexy for Glottic and Supraglottic Carcinomas .Laryngoscope, 2000；110：627-634
[14] 王斌全, 夏树信, 皇甫辉，等. 晚期喉癌切缘组织流式细胞仪参数及
PCNA表达的研究. 耳鼻咽喉-头颈外科，2003；10（3）：163-167.
[15] 王运钟. 喉癌手术切缘的研究. 国外医学耳鼻咽喉科学分册，1993；17（1）：13-16.