Limited Surgery for Cancer of the Larynx and Hypopharynx: Options and Consequences
Limited Surgery for Cancer of the Larynx and Hypopharynx: Options and Consequences
复制标题
喉和下咽癌的有限手术：选择和后果
DOI：
10.1080/000164802760057554
复制
发表时间：
2002
影响因子：
1.4
通讯作者：
M. Okamoto
中科院分区：
文献类型：
--
作者：
M. Nakayama;Hiro;K. Yao;K. Inagi;T. Makoshi;H. Nagai;M. Okamoto
我们回顾了喉癌和下咽癌中喉保留（有限手术）的手术选择以及这些选择的后果。在44例喉癌患者中，11例（25%）接受了有限手术，33例（75%）接受了全喉切除术。有限手术组的生存率为91%，总（根治）手术组的生存率为73%。在31例下咽癌患者中，7例（23%）接受了有限手术，24例（77%）接受了全喉咽切除术。有限手术组的生存率为53%，总（根治）手术组的生存率为40%。因此，对于喉癌和下咽癌，有限手术的生存率优于完全（根治性）手术。这是由于有限的手术组由精心挑选的局限病变的患者组成。器官保存手术在技术上应该是简单的，就其功能影响而言应该是可靠的，最重要的是，不应该危及病人的生存。环舌骨舌骨会厌骨固定术或环舌骨舌骨固定术在喉保护方面具有很大的潜力，将成为治疗喉癌的主要手术方式。然而，有限的手术需要非常小心地进行，并且只适用于非常精心挑选的下咽癌患者。
We reviewed surgical options for laryngeal preservation (limited surgery) in laryngeal and hypopharyngeal cancers and the consequences of the options. Of 44 patients with laryngeal cancer, 11 (25%) received limited surgery and 33 (75%) received total laryngectomy. The survival rates were 91% for the limited surgery group and 73% for the total (radical) surgery group. Of 31 patients with hypopharyngeal cancer, 7 (23%) received limited surgery and 24 (77%) received total laryngopharyngectomy. The survival rates were 53% for the limited surgery group and 40% for the total (radical) surgery group. The survival rates associated with limited surgery were thus better than those for total (radical) surgery for cancers of both the larynx and hypopharynx. This was attributed to the limited surgery group comprising well-selected patients with confined lesions. Organ preservation surgery should be technically simple, reliable in terms of its functional impact and, above all, should not jeopardize the patient's survival. Supracricoid subtotal laryngectomy with cricohyoidoepiglottopexy or cricohyoido-pexy has great potential for laryngeal preservation and will become the major limited surgery modality for treating cancer of the larynx. Limited surgery, however, needs to be performed with great care and is indicated only for very well-selected patients with cancer of the hypopharynx.