CAJ | 학술논문

目的分析70岁以上老年喉癌患者行喉功能保全手术的方法及疗效. 方法 136例原发喉癌患者,行声带切除34例,垂直半喉切除28例,喉声门上水平部分切除24例,喉3/4切除15例,次全喉切除29例,全喉切除环咽吻合术6例.T3-4期病灶切除后多采用颈部肌皮瓣修复.术后可在气管套管外放置麻醉气囊,练习进食. 结果全部患者术后1周均恢复发音功能,92例拔除气管套管.45例有不同程度呛咳,经过吞咽练习后好转,1例失败.围手术期无死亡.3年和5年生存率分别为78.7%和68.5%. 结论对70岁以上老年喉癌患者,术前评估准确、术式选择和围手术期处理得当,可行喉功能保全.
목적 분석70세이상노년후암환자행후공능보전수술적방법급료효. 방법 136례원발후암환자,행성대절제34례,수직반후절제28례,후성문상수평부분절제24례,후3/4절제15례,차전후절제29례,전후절제배인문합술6례.T3-4기병조절제후다채용경부기피판수복.술후가재기관투관외방치마취기낭,연습진식. 결과 전부환자술후1주균회복발음공능,92례발제기관투관.45례유불동정도창해,경과탄인연습후호전,1례실패.위수술기무사망.3년화5년생존솔분별위78.7%화68.5%. 결론 대70세이상노년후암환자,술전평고준학、술식선택화위수술기처리득당,가행후공능보전.
Objective To study the therapeutic effects of conservation surgery of laryngeal function for larygeal carcinoma in patients aged 70 years and over. Methods 136 patients aged 70 years and over were collected. Among them, 34 cases underwent vocal cord resection, 28 vertical hemilaryngectomy, 24 horizontal supraglottic hemilaryngectomy, 15 horizontovertical (3/4)laryngectomy, 29 subtotal laryngectomy, 6 total laryngectomy with cricopharyngeal anastomosis.Tissue defects were repaired by use of cervical myocutaneous flap in patients of T3-4 tumor stage. After operation, a special pneumatoeeles was attached on the tracheal cannula when eating.Results All patients had their phonation restored in a week. 92 cases were decannulated. 45 cases had cough and then were improved after respiration training and one case was in failure. No death occurred in the perioperative period. The survival rates were 78.7% at 3 years and 68.5% at 5 years.Conclusions Laryngectomy with reservation of laryngeal function is feasible in senile patients aged 70 years and over under conditions of correct indication, right choice of operation and thoroughly care during perioperative.