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目的 :探讨喉癌临床手术的安全切缘。方法 :分析 1996年 6月至 2 0 0 1年 6月山东大学齐鲁医院及烟台毓璜顶医院耳鼻咽喉科手术治疗 16 7例喉癌患者的临床资料 ,术前全面评估肿瘤 ,依据肿瘤特点分别采用甲状软骨中份旁侧入路 ,环甲膜入路 ,气管入路 ,咽侧入路 ,会厌谷入路 ,会厌根入路 ,根据肿瘤的原发部位、分期与特点切除范围相应不同 ;记录肿瘤扩展范围、复发、喉外侵犯、淋巴结转移的分布 ,统计复发率及生存率。结果 :3、5年失访分别为 3例和 4例 ,按复发和死亡计。 3、5年复发率为 15 12 2 (12 .3% )、2 3 94(2 4 .5 % ) ,生存率为 110 12 2 (90 .2 % )、73 94 (77.7% ) ;19例复发中单纯局部复发 11例 ,单纯颈部复发 5例 ,颈部和局部复发 3例 ,颈部复发 8例中 ,Ⅱ、Ⅲ、Ⅳ区、气管旁、锁骨上分别为 3、2、1、1、1例。淋巴结转移为2 31 1332 ,声门区 13 198,声门上区 110 5 5 4、跨声门型 10 3 5 32 ,声门下区 5 4 8;其中Ⅱ、Ⅲ、Ⅳ、V区分别为 12 1、78、13、9枚 ,喉前淋巴结 6枚 ,气管旁淋巴结 4枚。喉外侵犯甲状软骨板 19例 ,甲状腺 11例 ,气管 6例 ,接力肌 4例 ,胸骨舌骨肌 2例 ,舌根 9例。前连合、浸润性生长的深面切缘、会厌前间隙和舌根、披裂周围、软骨切缘以及Ⅱ区、喉前、气管旁淋巴?
Objective: To investigate the safety margin of laryngeal cancer surgery. Methods: From June 1996 to June 2001, clinical data of 167 cases of laryngeal carcinoma treated by Qilu Hospital of Shandong University and Yuhuangding Top Hospital of Yantai from June 1996 to June 2001 were analyzed. Thyroid cancer was evaluated comprehensively before surgery. Thyroid Cartilage in the side of the road, the ring membrane approach, tracheal approach, pharyngeal approach, metamorphosis into the road, epiglottic root approach, according to the tumor’s primary site, staging and characteristics of the corresponding excision range; record of the tumor Extended range, relapse, extra-laryngeal invasion, distribution of lymph node metastasis, statistical recurrence rate and survival rate. Results: The 3 and 5 year follow-up were 3 and 4, respectively, according to the recurrence and death. The recurrence rates at 3 years and 5 years were 15 12 2 (12.3%) and 23 94 (24.5%), respectively. Survival rates were 110 12 2 (90.2%) and 73 94 (77.7%) in 19 patients Recurrence of simple local recurrence in 11 cases, simple neck recurrence in 5 cases, neck and local recurrence in 3 cases, neck recurrence in 8 cases, Ⅱ, Ⅲ, Ⅳ area, tracheal, supraclavicular were 3,2,1, 1,1 cases. The lymph node metastasis was 2 31 1332, the glottis area was 13 198, the supraglottic area was 110 5 5 4, the transglucose type was 10 3 5 32, and the subglottic area was 5 4 8. The areas Ⅱ, Ⅲ, Ⅳ and V were 12 1,78,13,9 pieces, 6 pre-laryngeal lymph nodes, 4 para-tracheal lymph nodes. 19 cases of thyroid cartilage invaded thorax, 11 cases of thyroid, 6 cases of trachea, 4 cases of relay muscle, 2 cases of sternohyoid muscle and 9 cases of tongue base. Anterior commissure, deep cut edge of invasive growth, epiglottic anterior gap and tongue base, around the perforation, cartilage resection and Ⅱ area, pre-laryngeal, tracheal lymph?