比较全喉切除术后咽部粘膜的缝合技术:人工缝合、线性订书机和甲状腺瓣--回顾性分析。

Bo Han, LiZhen Hou, Sen Hao, Zhengxue Han, Jugao Fang, Jixiang Wu
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引用次数: 0

摘要

研究目的本研究旨在比较人工缝合(A组)、线性订书机(B组)和甲状腺皮瓣(C组)用于喉癌患者全喉切除术(TL)后咽部粘膜闭合的临床效果。方法分析2017年1月1日至2021年12月1日期间接受全喉切除术的喉癌患者数据。根据闭合技术将患者分为 A 组、B 组和 C 组。比较了各种参数,包括一般数据、住院天数、总费用、咽闭合时间、咽瘘、手术前后血钙水平和甲状腺功能指标。研究结果研究共纳入 81 例患者(平均年龄:64.09±9.20 岁),三组患者的一般数据具有可比性。各组患者的肿瘤分期和原发肿瘤位置差异显著(P = .002 和 P P = .006)。咽瘘发生率为17.28%(14/81),各组之间的发生率相当[A组为12.35%(10/50),B组为12.5%(2/16),C组为13.3%(2/15)]。在 2-5 年的随访期间,未发现吞咽困难并发症。三组患者的血钙水平和甲状腺功能指标在手术前后无明显差异(P > .05)。结论甲状腺瓣是一种安全的选择,可用于修复TL手术后的粘膜缺损并关闭咽腔,但在无粘膜缺损和肿瘤广泛侵犯的情况下,线性订书机是最省时省力的方法。
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Comparing Closure Techniques for Pharyngeal Mucosa After Total Laryngectomy: Manual Suture, Linear Stapler, and Thyroid Gland Flap-A Retrospective Analysis.

Objective: This study aimed to compare the clinical effectiveness of manual suture (group A), linear stapler (group B), and thyroid gland flap (group C) for pharyngeal mucosal closure after total laryngectomy (TL) in laryngeal cancer patients. Methods: The data of laryngeal cancer patients who underwent TL between January 1, 2017, and December 1, 2021, were analyzed. Patients were categorized into group A, group B, and group C based on the closure technique. Various parameters, including general data, hospitalization days, total cost, pharyngeal closure time, pharyngeal fistula, pre- and post-surgical calcium levels, and thyroid function indexes, were compared. Results: The study included 81 patients (mean age: 64.09 ± 9.20 years), the general data of the 3 groups of patients were comparable. Tumor stage and primary tumor location varied significantly among the groups (P = .002 and P < .001, respectively). Group A was more commonly used for advanced-stage tumors with widespread invasion. Group B was primarily used for early-stage tumors localized to the larynx. Group C was preferred for cases with mucosal defects or extensive hypopharyngeal invasion. Group B presented a significantly shorter operation time and slightly lower total cost (P = .006). Pharyngeal fistula incidence was 17.28% (14/81), with comparable rates among the groups [12.35% (10/50) in group A, 12.5% (2/16) in group B, and 13.3% (2/15) in group C]. No dysphagia complications were observed during the 2-to-5-year follow-up. Blood calcium levels and thyroid function indicators showed no significant differences before and after surgery among the 3 groups (P > .05). Conclusion: Thyroid gland flap is a safe option that can be used to repair mucosal defects and close the pharyngeal cavity after TL surgery, but in the absence of mucosal defects and widespread tumor invasion, linear staplers are the most time-efficient method.

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