喉癌的手术方式选择及远期疗效的分析

刘红兵; 刘月辉; 罗英

doi:10.3969/j.issn.1007-3969.2015.02.011

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喉癌的手术方式选择及远期疗效的分析

更新时间：2025-12-31

- 喉癌的手术方式选择及远期疗效的分析
- Analysis of surgical methods and clinical analysis of its long-term effect of laryngeal carcinoma
- 中国癌症杂志 2015年25卷第2期页码：145-149
- 作者机构：
  
  南昌大学第二附属医院耳鼻咽喉头颈外科,江西,南昌,330006
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.1007-3969.2015.02.011
  中图分类号：
- 网络出版：2015-05-13，
  
  纸质出版：2015-05-13
- 稿件说明：
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刘红兵,刘月辉,罗英,等. 喉癌的手术方式选择及远期疗效的分析[J]. 中国癌症杂志, 2015, 25(2): 145-149.

刘红兵, 刘月辉, 罗英. Analysis of surgical methods and clinical analysis of its long-term effect of laryngeal carcinoma[J]. China Oncology, 2015, 25(2): 145-149.
刘红兵,刘月辉,罗英,等. 喉癌的手术方式选择及远期疗效的分析[J]. 中国癌症杂志, 2015, 25(2): 145-149. DOI： 10.3969/j.issn.1007-3969.2015.02.011.

刘红兵, 刘月辉, 罗英. Analysis of surgical methods and clinical analysis of its long-term effect of laryngeal carcinoma[J]. China Oncology, 2015, 25(2): 145-149. DOI： 10.3969/j.issn.1007-3969.2015.02.011.

摘要

背景与目的：外科手术是喉癌的主要治疗方法之一，但不同的术式对患者生存时间及生活质量会产生不同的影响，本研究旨在分析喉癌手术治疗的术式及其远期疗效，以提高其生存率、喉功能保存率及生存质量。方法：对2002年1月—2012年12月手术治疗的424例喉癌患者进行临床随访、资料分析。手术方式：支撑喉镜下CO

激光切除术50例，未行气管切开的额前位或改良甲状软骨窗式部分切除术42例，垂直侧前位喉部分切除术119例，水平半喉切除术及扩大水平喉次全切除22例，咽气管吻合(Arslan)手术4例，环上喉次全切除术(supracricoid partial laryngectomy，SCPL)129例［环状软骨-舌骨-会厌固定术(cricohyoidopiglottpery，CHEP)103例，环状软骨-舌骨固定术(cricohyoidopery，CHP)26例］，全喉切除术58例，同期行颈淋巴结清扫121例。结果：未行气管切开者共92例，占21.7%，全喉切除者共58例，占13.7%；气管切开喉部分切除术者拔管率为86.5%，其中行垂直侧前位喉部分切除术占93.2%，行水平半喉切除术率占90.9%，环上喉次全切除术拔管率为82.2%；喉功能保存率为86.3%；所有患者进行门诊复查或电话随访，9例失访，肿瘤复发、颈部淋巴转移及远处转移共41例，大多发生于术后1年以内；死亡57例，其中复发8例、颈部转移13例、肺转移5例、肝转移2例、脑转移1例、食管转移1例、肺部感染6例、急性肾功能衰竭2例、不明原因19例，以Kaplan-Meier法统计生存率，3年生存率为90.7%，5年生存率为84.1%，复发及转移是其死亡的主要原因。结论：喉癌的治疗以手术为主，根据肿瘤分期、发病部位、年龄、患者的职业及文化程度、全身状况等，制定个体化手术治疗方式，在保证肿瘤彻底切除的前提下，多主张功能性手术及微创手术，同时应采取综合治疗，从而尽可能提高患者生存率，减少痛苦，并提高患者术后生存质量。

Abstract

Background and purpose: Surgical operation is the main method in the treatment of laryngeal carcinoma

but different patients have different impacts on the survival time and the quality of life with different type of operation. This study was to analyze the methods of surgical treatment and its long-term effect of laryngeal carcinoma

to increase survival rates

laryn

geal function reservation and reconstruction and improve life quality. Methods: A total mumber of 424 patients of laryngeal carcinoma treated with surgical treatment during between Jan. 2002 and Dec. 2012 were researched by clinical follow-up and data analysis. Surgical method: CO

laser-assisted laryngeal microsurgery for laryngeal tumors for 50 cases

frontal partial laryngectomy or modified thyroid cartilage window partial laryngectomy without tracheostomy for 42 cases

vertical frontolateral partial laryngectomy for 119 cases

horizontal partial laryngectomy and extended subtotal laryngectomy for 22cases

anastomosis of pharynx and trachea for 4 cases

supra cricoid partial laryngectomy for 129 cases (CHEP of them for 103 cases

CHP for 26 cases)

total laryngectomy for 58 cases

cervical lymph node dissection at the same term for 121 cases. Results: Partial laryngectomy without tracheostomy for 92 cases (21.7%)

total laryngectomy for 58 cases (13.7%); decannulation rate was 86.5%

vertical frontolateral partial laryngectomy of them for 93.2%

horizontal partial laryngectomy of them for 90.9%

supra cricoid partial laryngeal of them for 82.2%; laryngeal function reservation rate for 86.3%; all patients did outpatient review and telephone follow-up

9 cases loss to follow-up

a total of tumor recurrence

cervical lymph node metastasis and distant metastasis were 41 cases

mostly occurred in 1 year after surgery; death for 57 cases

relapse of them for 8 cases

cervical metastasis for 13 cases

pulmonary metastasis for 5 cases

hepatic metastases for 2 cases

brain metastases for 1 case

esophagus metastases for 1 case

pulmonary infection for 6 cases

acute renal failure for 2 cases

unknown reason for 19 cases

according to Kaplan-Meier to count survival rate

3-year and 5-year survival rate were 90.7% and 84.1%

relapse and metastasis were the main causes of death. Conclusion: Surgical treatment is the main therapy mode of laryngeal carcinoma. We choose individualized surgical methods for patients

according to tumor staging

invasion site

age

occupation and education background of patient

health condition and so on. On the premise that tumor is completely cut off

we always advocate function surgery and minimally invasive surgery

and adopt comprehensive treatment at the same time

in order to increase survival rates

lesson suffering and improve life quality as far as possible.

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