Narrow-field supracricoid partial laryngectomy: Procedure development and initial clinical experiences
Narrow-field supracricoid partial laryngectomy: Procedure development and initial clinical experiences
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窄视野环上喉部分切除术：手术进展和初步临床经验
DOI：
10.1016/j.anl.2022.09.011
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发表时间：
2023
影响因子：
1.7
通讯作者：
Orosco Ryan
中科院分区：
文献类型：
--
作者：
Nakayama Meijin;Wada Takashi;Isono Yasuhiro;Sano Daisuke;Nishimura Goshi;Oridate Nobuhiko;Holsinger F. Christopher;Orosco Ryan
目的探讨窄视野环状软骨上喉部分切除环舌会厌固定术（NF-SCPL-CHEP）的可行性。评估了手术引流、气管切开插管和鼻胃管使用的平均持续时间。将NF-SCPL-CHEP后的住院时间与我们的开放SCPL历史对照进行比较。提供了第一个病人的情况摘要，术后管理和function.ResultsAll五例患者术后恢复顺利，没有重大并发症的详细信息。手术引流、气管切开插管和鼻胃管使用的平均时间分别为2、15和46天。NF-SCPL-CHEP患者的平均总住院时间为36天。根据我们1997年至2005年使用经典开放式SCPL的早期经验，平均住院时间为72天。所有患者的功能和局部复发或远处转移，没有遇到在平均观察期为39 months. ConclusionsNF-SCPL-CHEP与6厘米的颈部访问出现在技术上是可行的，在这个初步的临床经验的肿瘤声音。额外的2厘米切口可以进行侧颈清扫术，但并不影响NF-SGPL-CHEP的整体微创基础。临床结果令人鼓舞，并发症少，术后恢复可预测。NF-SCPL患者的住院时间是开放SCPL历史对照的一半。对局部循环的损害较小，可能与其积极的影响有关。需要在多个机构进行大样本患者的进一步研究，以仔细评估长期功能和肿瘤结局。
ObjectivesTo evaluate the feasibility of narrow-field supracricoid partial laryngectomy with cricohyoidoepiglottopexy (NF-SCPL-CHEP).MethodsBetween 2019 and 2020, five patients with glottic cancers underwent NF-SCPL-CHEP. The mean durations of surgical drains, tracheostomy canula, and nasogastric tube use were evaluated. Length of stay following NF-SCPL-CHEP was compared with that of our open SCPL historical controls. A case summary is provided for the first patients, with detailed information about postoperative management and function.ResultsAll five patients achieved uneventful postoperative recoveries without major complications. The average time for surgical drains, tracheostomy canula, and nasogastric tube use were 2, 15, and 46 days, respectively. The mean overall hospitalization period was 36 days for NF-SCPL-CHEP patients. The mean period of hospitalization based on our early experiences between 1997 and 2005 with classical open SCPL was 72 days. All patients were fully functional and local recurrences or distant metastases were not encountered during a mean observation period of 39 months.ConclusionsNF-SCPL-CHEP with 6 cm cervical access appeared technically feasible and oncologically sound in this initial clinical experience. An extra 2 cm incision, which enabled lateral neck dissection, was not felt to detract from the overall minimally invasive basis of NF-SCPL-CHEP. The clinical results were encouraging with limited complications and predictable postoperative recovery. The length of stay for patients undergoing NF-SCPL was half that of open SCPL historical controls. Less damages to local circulation may associate with the positive influences. Further study with a large patient sample across multiple institutions are needed to carefully evaluate long-term functional and oncological outcomes.