孟加拉国地区医院全喉切除术的效果

IF 0.1 Q4 OTORHINOLARYNGOLOGY
M. Islam, Md. Shahjahan Kabir, Md. Abdullah Yousuf Al Harun, Md. Abdur Razzak, Mohosana Khanam, A. S. Uddin, A. Sobhan, M. Matin
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引用次数: 1

摘要

目的:分析全喉切除术后的并发症、局部复发、言语和吞咽功能结果以及生存率。方法:这项前瞻性观察性研究于2000年7月至2019年12月在孟加拉国四所主要的三级护理医学院医院进行。所有的手术都是由一名外科医生完成的,这项研究的作者之一基于个人经验。选择45例经病理证实为晚期(T3和T4)喉癌症的患者进行全喉切除术,作为放疗后的原发病例和复发病例。患者每月随访三个月,然后六个月随访两年,余生每年随访一次。结果:患者年龄42~80岁,平均56.7岁。术后有03例(6.6%)患者出现伤口感染,03例(6.6%)口腔狭窄,03例复发,02例(4.4%)浆膜瘤,02例咽皮瘘,01例(2.2%)出现咽狭窄。在喉切除术后的语音康复中,33例(73.3%)使用食道音,07例(15.5%)使用电喉,05例(11.1%)使用bloom-singer瓣膜。在食道言语之外,2名患者的言语能力较差。关于吞咽,除了一名患者出现咽部狭窄,需要扩张外,所有患者的吞咽能力都很好。3例患者在随后的2年随访中死亡,总生存率为93.3%。结论:全喉切除术的结果取决于肿瘤的部位和大小、淋巴结转移、复发病例和合并症。与仅接受放疗相比,接受或不接受放疗的全喉切除术对晚期癌症的局部控制和生存益处显著更高。孟加拉国耳鼻喉科杂志2021;27(2):139-144
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcome of Total Laryngectomy in Regional Hospitals of Bangladesh
Objectives: To analyze post operative complications, local recurrence, functional outcome of speech & swallowing and survival rate following total laryngectomy. Methods: This prospective observational study was done in four major tertiary care medical college hospitals of Bangladesh from July 2000 to December 2019. All operations were done by a single surgeon, one of the authors of this study based on the personal experience. 45 patients were selected who underwent total laryngectomy for biopsy proven advanced (T3 and T4) laryngeal cancer as primary case & recurrent cases following radiotherapy. Patients were followed up monthly for three months and then six monthly for two years and yearly for rest of their life. Results: Age of the patients ranged from 42 to 80 years with mean age 56.7 years. In postoperative period 03 (6.6%) patients developed wound infection, 03 (6.6%) stomal stenosis, 03 (6.6%) stomal recurrence, 02 (4.4%) seroma, 02 (4.4%) pharyngo-cutaneous fistula and 01 (2.2%) case developed pharyngeal stenosis. In post laryngectomy voice rehabilitation 33 (73.3%) cases used esophageal voice, 07 (15.5%) cases used electrolarynx and 05 (11.1%) cases used bloom singer valve. Out of oesophageal speech, 2 patients had poor speech, Regarding swallowing all patients had very good swallowing except one patient who got pharyngeal stenosis, needed dilation. 3 patients died in subsequent 2 years follow-up and overall survival was 93.3%. Conclusion: Outcome of total laryngectomy depends on site and size of tumour, nodal metastases, recurrent cases and co-existing co-morbidities. Total laryngectomy with or without radiotherapy offers significantly higher local control and survival benefit with advanced laryngeal cancer, compared to radiotherapy only. Bangladesh J Otorhinolaryngol 2021; 27(2): 139-144
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