论文部分内容阅读
全喉切除是治疗喉癌的一种有效方法。但术后带来一系列的功能破坏,如终生带气管套管,发音困难等。近些年来国内外相继报道喉切除后发音重建术,即将气管提高到舌骨水平,行气管咽吻合,可保持较好的发音功能,为全喉切除术的一大改进。1980年以前我科亦多采用这种术式,但部分病人仍存在有克服误咽不彻底以及拔管率不高需终生带管等缺点。根据喉的解剖学和喉癌病理学特点及喉癌的分区,对部份经选择的病例,在根除肿瘤的前提下,施行部份喉切除,尽量保全正常喉组织,不仅能达到全喉切除的疗效,而且能大部保全喉的生理功能。因此,对所有喉癌,不论其范围及部位,不加区别地一律施行全喉切除是不恰当的。
Total laryngectomy is an effective method for the treatment of laryngeal cancer. However, after the operation, it brings a series of functional damages, such as lifelong tracheal cannula, difficulty in speech and so on. In recent years, there have been reports of reconstructive surgery after laryngectomy at home and abroad, which means that the trachea is increased to the level of the hyoid bone, and tracheal-pharyngeal anastomosis is performed. This can maintain good pronunciation function and is a major improvement in total laryngectomy. Before 1980, our department also adopted this type of surgical procedure. However, some patients still have the disadvantages of overcoming the incomplete swallowing and the lack of extubation rate and the need to wear tubes for life. According to the anatomy of the larynx and the pathological features of laryngeal carcinoma and the zoning of laryngeal cancer, partial laryngectomy was performed on some selected cases to preclude the removal of tumors, and normal laryngeal tissue was preserved as far as possible to achieve not only total laryngectomy. The efficacy, but also most of the preservation of the physiological function of the throat. Therefore, it is not appropriate for all laryngeal cancers to perform total laryngectomy indiscriminately, regardless of their scope or location.