[Total glossectomy with laryngectomy].

P Gehanno, C Guedon, B Baujat, J Depondt, B Barry
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引用次数: 0

Abstract

Because local control of locally advanced cancer of base of tongue and larynx managed with combined chemotherapy and radiotherapy is poor, we proposed total glossectomy with total laryngectomy. Twenty-one patients underwent this operation over a period of 8 years. It was a salvage surgery for 15 patients, and an up-front surgery for the 6 others. Postoperative complications occurred in ten patients, and three patients died in the postoperative period. Mean total duration of hospitalisation was 40 days. Oral feeding could be achieved in 14 patients (mean delay: 46 days), but satisfactory oesophageal voice has never been obtained. We can conclude from the analysis of this series that total glossectomy with total laryngectomy is a heavy surgery, which leads to frequent complications, severe functional sequellae, and poor survival. However, control of pain can be obtained, that justifying this heavy procedure. We recommend that patients and relatives should be fully informed about the consequences of surgery before final decision.

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全舌切除术合并喉切除术。
由于局部晚期舌、喉底癌经放化疗联合治疗的局部控制较差,我们提出全舌切除加全喉切除术。在8年的时间里,21名患者接受了这种手术。这是对15个病人的救助手术,对另外6个病人的预先手术。术后并发症10例,术后死亡3例。平均总住院时间为40天。14例患者可实现口服喂养(平均延迟46天),但从未获得满意的食管声音。从这一系列的分析中我们可以得出结论,全舌切除合并全喉切除术是一项繁重的手术,并发症频繁,功能后遗症严重,生存率低。然而,疼痛的控制是可以获得的,这证明了这种沉重的手术是合理的。我们建议患者和家属在做最终决定前应充分了解手术的后果。
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