| ObjectiveTo compare and analyze the clinical data of patients with T3 stage glottic laryngocarcinoma who received supracricoid partial laryngectomy with cricohyoidoepiglottop and total laryngectomy,and to explore the clinical effect of supracricoid partial laryngectomy with cricohyoidoepiglottop in the treatment of T3stage glottic laryngocarcinomaMethodsThe clinical data of 119 patients with T3 stage glottic laryngocarcinoma treated by cricohyoidoepiglottopexy and total laryngectomy from March 2014 to July 2016in our hospital were analyzed retrospectively.Among them,118 cases were male and1 case was female.The average age was 60.12±6.72 years old.51 patients who received cricohyoidoepiglottopexy were set as the observation group and 68 patients who underwent total laryngectomy as the control group.The patients were followed up 29-59 months by outpatient or telephone,and the follow-up time of all cases was up to December 2019.Spss21.0,a statistical software,was used to compare and analyze the operation duration,intraoperative bleeding volume,indwelling gastric tube time,postoperative time to the start of radiotherapy,postoperative complications during hospitalization,recurrence in 3 years,total score of quality of life score of Washington University,and survival of the two groups.The difference was statistically significant(P<0.05).Results(1)Operation time:observation group(324.02±52.35)min,control group(323.26±40.66)min,no significant difference(P>0.05).(2)Intraoperative blood loss:observation group(157.88±41.09)ml,control group(164.01±36.87)ml,the difference was not statistically significant(P>0.05).(3)Indwelling gastric tube time:18(14?23)days in the observation group and13.50(12?15)days in the control group,the difference was statistically significant(P<0.05).(4)Postoperative time to the start of radiotherapy:21(18?30)days in the observation group and 21(18?25)days in the control group,the difference was not statistically significant(P>0.05).(5)Postoperative complications during hospitalization:in the observation group,there were 6 cases of pulmonary infection,1 case of pharyngeal fistula and 2 case of postoperative laryngeal stenosis;5 cases of pharyngeal fistula and 2 cases of tracheostomy infection in the control group.The difference was not statistically significant(P>0.05).(6)3-years recurrence after operation:10 cases in the observation group and 10cases in the control group,the difference was not statistically significant(P>0.05).(7)The quality of life after surgery was evaluated by the University of Washington Quality of Life Scale(UW-QOL):the observation group scored 1142(1117?1175)and the control group scored 1008(975?1050),the difference was statistically significant(P<0.001).(8)Survival analysis:in the observation group,8 cases died of laryngocarcinoma,2 cases died of severe lung infection,2 cases died of cardiovascular and cerebrovascular diseases;in the control group,9 cases died of laryngocarcinoma and 4 cases died of cardiovascular and cerebrovascular diseases.The Kaplan-Meier was used for survival analysis,and log-rank method was used to compare the survival curve of two groups.The 3-year cumulative survival rates of the observation group and the control group were 80.9%and 88.5%,respectively,with no statistically significant difference(?~2=0.609,P=0.435).The 3-year cumulative disease-specific survival rates of the observation group and the control group were84.6%and 93.4%,respectively,with no significant difference(?~2=0.609,P=0.435).(9)Tracheal tube extubation:the rate of tracheal tube extubation in 51 patients in the observation group was 100%,and in the control group,all patients underwent tracheostomy for life.ConclusionIn the treatment of selective T3 glottic carcinoma,supracricoid partial laryngectomy with cricohyoidoepiglottop and total laryngectomy have the same effect,but the postoperative quality of life is significantly higher than total laryngectomy,avoiding permanent tracheostomy.Strictly grasp the indications,supracricoid partial laryngectomy with cricohyoidoepiglottop can replace partial total laryngectomy. |
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