| Objective To compare the two surgical methods of total laryngectomy: traditional surgical methods and linear closure surgical methods for clinical cases,a retrospective study was carried out to compare the efficacy and advantages and disadvantages of the two methods.Method Retrospective analysis During the period from March 2015 to March 2018,30 patients(experimental group)underwent total laryngectomy with a linear occlusion device at the First Affiliated Hospital of Zhengzhou University.A total of 30 patients(control group)who underwent total laryngectomy with conventional manual suture in our hospital were collected.Compare the operation duration,oral feeding days,days of suture removal,postoperative days to discharge,pharyngeal incidence,recurrence rate,1-year mortality,3-year mortality,and postoperative pharyngeal fistula The difference between the symptoms,explore the advantages and disadvantages of linear occluder and clinical practical value.Result Compared with the traditional manual group(control group),the closure time of the closed group(experimental group)decreased by 59 minutes on average,the number of postoperative oral feeding days decreased(3.0 days),and the number of postoperative suture removal days decreased(1.6 days).The number of days is reduced(3.4 days).The closure group was compared with the manual group.The length of operation,the number of postoperative oral feeding days,the number of postoperative suture days,and the number of postoperative hospital stays were reduced.The P values were 0.039,0.002,0.002,and 0.002(P values were all less than 0.05),there are differences in statistics.The postoperative complications were phlegm and blood stasis P=0.045(P<0.05),which was statistically significant.Postoperative other postoperative complications of chyle and hemorrhage,P value were: 1.000,0.561(P value is greater than 0.05),there is no statistically significant difference,the closure group can reduce the incidence of postoperative pharyngeal fistula,bleeding,The improvement of chyle is meaningless.Due to the case collection time range from March 2015 to March 2018,the cumulative recurrence rate and mortality rate for the first,second and third years were calculated according to the group of 1 year,2 years and 3 years.The Linear closer group: 1 year recurrence rate was 10.00%,mortality was 0.00%;postoperative recurrence rate was 19.00%,mortality was 6.25%;postoperative recurrence rate was 18.18% and mortality was 0.00%.The Traditional manual group: the recurrence rate was 23.33% after 1 year,the mortality rate was 10.00%;the recurrence rate was 23.08% after 2 years,the mortality rate was 15.38%;the recurrence rate was 10.33% and the mortality rate was 0.00% after 3 years.After 1-3 years,the cumulative recurrence rate and mortality P value of each year were greater than 0.05,which was statistically meaningless.Conclusion 1.There was no difference in the effect of the linear closure group on the recurrence rate and mortality outcome.There was no difference in cumulative recurrence rate and mortality between the linear closure group and the traditional manual group at 1 year,2 years,and 3 years.2.The linear occluder group can significantly reduce the incidence of postoperative pharyngeal fistula,reduce the length of surgery,reduce the number of postoperative oral feeding,suture removal,hospitalization.3.The use of the closure needs to strictly grasp the surgical indications.4.The linear occluder has simple and quick operation and simplifies the surgical procedure.The operation has standardized features,which is convenient for physician training and shortens the growth time of young doctors' surgical training.5.In the actual clinical application,according to the actual situation of the patient,such as economic ability,systemic condition,tumor range,etc.,comprehensive consideration of which surgical method. |
PDF Full Text Request