Đánh giá kết quả phẫu thuật cắt bán phần thanh quản trên nhẫn kiểu chep điều trị ung thư thanh quản giai đoạn sớm

Abstract

Objective: To evaluate results of supracricoid partial laryngectomy with crico-hyoido-epiglottopexy (CHEP) in treament early-staged laryngeal cancer. Methods: Case study with 27 patients diagnosed with T1 or T2 laryngeal canceri and treated by supracricoid  partial laryngectomy with crico-hyoido-epiglottopexy in Ho-Chi-Minh city ENT Hospital from December 2018 to April 2022. Results: Our study shows an 8:1 male to female ratio, with average age of 59.48 ± 6.4, smoking habit accounting for 77.8%, and 3-month hoarseness accounting  for 51.8%. T1 stage constitutes 85%, NO: 100%. Average post-op period is 17.6 ± 4.2 days. Complications occur in 29.6% of all cases. Doubtful surgical margins are in 18.5% (5 cases); 2 cases of dysplasia are routinely followed up; 3 positive margins are irradiated. Recurrent rate is 3.7%. Resection of one arytenoid accounts for 11 % (3 cases). The average time elapsed before de-cannulation is 12.4 ± 6.5 days. Age and respiratory function are not relevant to the duration time of breathing recovery (p = 0.3 and 0.28). Arytenoid cartilage resection is relevant to the duration time of breathing recovery (p = 0. 049). 96.3% of all cases are trained with breathing exercises at the fifth day post-op. The average time elapsed before oral feeding is 11.3 ± 5.7 days. The times elapsed before decannulation and oral feeding are tightly correlated with r = 0.64 (p < 0.01). All cases are trained with swallowing exercises at the seventh day post-op. Swallowing has mild effect to quality of life with MD Anderson score ranging from 79 to 82%. The total average VHI-10 index is 22/40. Conclusions: Supracricoidpartial laryngectomy with crico-hyoido-epiglottopexy is a safe procedure that is capa­ble of resecting the tumor, reconstructing the larynx and preserving the laryngeal physiological functions.