Comparative Analysis Of Vocal Cord Resection Combined With Keel Implantation And Epiglottis Anastomosis For The Treatment Of Glottic Laryngeal Carcinoma With Anterior Involvement

ObjectiveVocal cord resection combined with keel implantation and epiglottis anastomosis are two surgical methods for the treatment of pre-involved glottic laryngeal carcinoma.The case data of these two surgical methods were retrospectively analyzed.Analyze the difference,advantages and disadvantages of the two.MethodA retrospective analysis of 86 cases of patients with glottic laryngeal cancer who were involved in the pre-combination of glottic laryngeal cancer at the throat and neck surgery of the First Affiliated Hospital of Zhengzhou University from June 2011 to June 2016.There were 48 cases in the keel implantation group and 38 cases in the epiglottic anastomosis group.3-year survival rate,1-year,2-year,3-year local recurrence rate,clogging time,extubation time,extubation rate,nasal feeding time,number of reoperations,postoperative hospital stay,and postoperative complications for the two groups of patients Observe and follow up for 3 years.ResultThe 3-year survival rate of the vocal cord resection and keel implantation group was 93.75%(45/48),and the 3-year survival rate of the epiglottis anastomosis group was 97.37%(37/38).There was no statistically significant difference between the two(P>0.05);the one-year local recurrence rate in the vocal cord resection and keel implantation group is 6.25%(3/48),the two-year local recurrence rate is 10.42%(5/48),and the one-year local recurrence rate in the epiglottis anastomosis group At 0 and 2 years,the local recurrence rate was 2.70%(1/38),and there was no significant difference between the two(P>0.05).The 3-year local recurrence rate of the vocal cord resection and keel implantation group was 18.75%(9/48)higher than the 3-year local recurrence rate of the epiglottis anastomosis group.The difference between the two was statistically significant(P<0.05);the occlusion time of the vocal cord resection and keel implantation group was 9.71 ± 1.68 days,which was lower than the 12.58±1.77 days of the epiglottis anastomosis group.The difference between the two was statistically significant(P<0.05);The extubation time of the keel implantation group was 37.13±6.76 days,which was higher than the 30.03±5.78 days of the epiglottis anastomosis group.The difference between the two was statistically significant(P<0.05);vocal cord resection and keel implantation group extubation The rate of 79.16%(38/48)was lower than the extubation rate of 97.37%(37/38)of the epiglottis anastomosis group,the difference between the two was statistically significant(P<0.05);the nasal feeding time of the vocal cord resection and keel implantation group 9.56±2.22 days was lower than that of the epiglottis anastomosis group.The nasal feeding time was 11.13±2.28 days,the difference between the two was statistically significant(P<0.05);The number of reoperations in Yuhuan epiglottis anastomosis group was 1.11±0.31 times,the difference between the two was statistical Significance of study(P<0.05);the postoperative hospital stay in the vocal cord resection and keel implantation group was 10.33±1.43 days lower than that in the epiglottis anastomosis group.The postoperative hospital stay was 12.82±1.48 days,the difference between the two was statistically significant(P<0.05);the probability of postoperative complications in the vocal cord resection and keel implantation group was 6.25%(3/48),and the probability of postoperative complications in the epiglottis anastomosis group was 5.26%(2/38),2 There was no statistically significant difference between the two groups(P>0.05).ConclusionVocal cord resection and keel implantation can shorten the time of tube obstruction,reduce the time of indwelling gastric tube,and the length of postoperative hospital stay.Advantages,the use of circumnegative anastomosis is recommended in clinical practice.