ObjectiveTo explore the feasibility of reconstruction of phonatory function by using a tubular free flap from upper-lateral upper arm to repair the laryngotracheal circumferential defect after near-total laryngectomy for laryngeal cancer. Methods A retrospective study was conducted on 7 patients who underwent near-total laryngectomy between June 2021 and October 2023, aged from 48 to 70 years (median, 59 years), 6 males and 1 female. The disease duration ranged from 1 to 11 months, with a median of 6 months. Pathological diagnosis of preoperative biopsy was squamous cell carcinoma. Tumor classification: glottic type in 5 cases, supraglottic type in 1 case, transglottic type in 1 case; TNM staging: T4N0M0 in 6 cases, T4N2M0 in 1 case; American Joint Committee on Cancer (AJCC) staging in 2017 was stage Ⅳ. Preoperative MRI angiography of upper arm was performed to investigate the blood supply in the upper and lateral regions of the upper arm. After near-total laryngectomy and bilateral neck lymph node dissection, the area of the laryngotracheal defect was measured. A free flap measuring 7.0 cm×5.0 cm to 8.0 cm×7.0 cm was harvested from the upper-lateral upper arm, rolled into a tube shape, and connected between the stump of the cervical trachea in the neck root and that of the epiglottis at the tongue base. Four patients received adjuvant radiochemotherapy, 1 patient received radiochemotherapy and targeted therapy, 2 patients adopted no further adjuvant treatment. Results All 7 patients were followed-up 1-2 years (mean, 1 year and 3 months). Four patients had primary wound healing, 2 patients had minor pharyngeal fistulas that healed after dressing change, 1 patient experienced pharyngeal fistula because of flap necrosis and the wound still healed without secondary surgery. All patients took food orally within 1 month after operation, and the tracheal cannula was retained. Six patients with survived flap gradually adapted to their new pronunciation mode and obtained satisfactory phonatory function from 15 days to 2 months after operation. Four patients had slight aspiration after operation. Till the end of the follow-up, all patients survived and no local recurrence or distant metastasis had been observed. The motor function of the upper arm was not affected, only partial sensory loss occurred in the area near the incision. The scar of the incision could be covered by the short sleeve so as to obtain a better aesthetic effect. ConclusionUsing a tubular free flap from upper-lateral upper arm to repair the laryngotracheal circumferential defect after near-total laryngectomy for laryngeal cancer can achieve satisfactory phonatory restoration while preserve the motor function and aesthetics of the donor site.
From Nov. 1988 through Apr. 1994, 78 cases with laryngocarcinoma underwent laryngectomy and laryngeal reconstruction by the use of transfered cervical skin. Three to six months after operation, all patients were subjected to direct or indirect laryngoscope. It was found that the keratinized of layer of the transfered skin tended to be thining out, and that hair had grown in one case. With the followup ranging from 3 months to 5 years,the results were good. All patients following the reconstruction of larynx could phonate, swallow and breath. Postoperatively, 32 patients were alive for 3 years, 2 patients died from recurrence of laryngocarcinoma. The complications included laryngeal fistula in 6 cases and laryngostenosis in 2 cases. The cause as well as the prevention of complications were discussed. It was suggested that thetransfer of cervical flap was feasible for laryngeal reconstruction.
ObjectiveTo comprehensively analyze the disease burden of respiratory cancers in China from 1990 to 2021, and predict the trend of disease burden changes from 2022 to 2031, in order to improve its prevention and treatment strategies. MethodsData from the Global Burden of Disease (GBD) 2021 database were extracted and analyzed for the disease burden of nasopharyngeal cancer, laryngeal cancer, and tracheal, bronchial and lung cancers (hereinafter referred to as lung cancer) in China from 1990 to 2021. The Joinpoint 4.9.1.0 software was utilized to analyze the corresponding trends. The grey prediction model [GM (1,1)] was employed to forecast the disease burden of respiratory cancers in China from 2022 to 2031. ResultsThe disease burden of respiratory cancers attributed to tobacco and occupational carcinogens in China raised from 1990 to 2021. Among the respiratory cancers, lung cancer led in terms of incidence, mortality, and disability-adjusted life years (DALY) and their respective age-standardized rates from 1990 to 2021, followed by nasopharyngeal cancer, with laryngeal cancer being the lowest. Analysis via the Joinpoint regression model indicated that, overall, the disease burden of nasopharyngeal and laryngeal cancers in China decreased during this time period, while that of lung cancer increased. From a gender perspective, the disease burden of male patients was significantly higher than that of female patients from 1990 to 2021. Compared to the global average, the disease burden of respiratory cancers in China from 1990 to 2021 was still relatively heavy. As of 2021, the middle-aged and elderly population above 50 years old was the primary group suffering from the disease burden of respiratory cancers in China. The prediction model showed that the age-standardized rate of nasopharyngeal cancer in China would decline from 2022 to 2031; the age-standardized incidence rate of laryngeal cancer in China would increase, while its age-standardized mortality rate and DALY rate would both decrease; the age-standardized rates of lung cancer in China would increase. ConclusionIn the past 30 years, the disease burden of nasopharyngeal and laryngeal cancers in China has lightened, but the overall disease burden of lung cancer is still on the rise. Compared to the global average, the disease burden of respiratory cancers in China is still relatively heavy. The disease burden in male patients is significantly higher than that in female patients, and the population above 50 years old is the main group suffering from the disease burden. In the next 10 years, the disease burden of respiratory cancers in China will still tend to increase. Therefore, targeted prevention and treatment strategies for men and the middle-aged and elderly populations remain key challenges that urgently need to be addressed in China's response to respiratory cancers.
摘要:目的: 探討選擇性內皮素A受體拮抗劑BQ123對人喉癌Hep2細胞裸鼠種植瘤的生長及血管形成的影響。 方法 :將實驗動物裸鼠隨機分為3組:BQ123［n =8,2mg/(kg·day)］、氟尿嘧啶組［n =8,2mg/(kg·day)］、生理鹽水組(n =8),比較各組裸鼠成瘤體積、微血管密度(MVD)。 結果 :BQ123組腫瘤體積為(162±053)cm3,明顯小于生理鹽水組及氟尿嘧啶組,差異具有統計學意義;BQ123組的腫瘤組織中MVD高倍鏡下為232,明顯低于生理鹽水組(586)及氟尿嘧啶組(395),差異具有統計學意義。 結論 :BQ123對人喉癌Hep2細胞在裸鼠體內有明顯抑瘤作用,腫瘤的體積、腫瘤組織MVD顯著低于對照組,表明BQ123可通過抑制腫瘤血管生成而顯著抑制腫瘤生長。Abstract: Objective: To study the effects of endothelin A receptor blockade BQ123 on the implanted human laryngeal carcinoma angiogenesis of nude mouse. Methods : From March 2008 to July 2009, 24 Balb/c nude mice were randomly divided into three groups: BQ123 group ［〖WTBX〗n =8, BQ123 at 2mg/(kg·day)］, 5Fu group ［〖WTBX〗n =8, fluorouracil at 2mg/(kg·day)］ and the control group (〖WTBX〗n =8, normal saline). The carcinoma volume and microvascular density of each group were compared. Results : The tumor size of BQ123 group, which was (162±053)cm3 in average, was significant smaller than the tumor sizes of the other two group s. The average microvascular density score of the tumors in BQ123 group was 232 per hyper power len (HP), which was also significantly less than the average scores of control groups (586 and 395 respectively). Conclusion : Nude mouse experiments show that the carcinoma volume and microvascular density of BQ123 group are significantly lower than those of the control groups. BQ123 inhibits the growth of carcinoma by its inhibition of carcinoma angiogenesis.
【摘要】目的探討喉癌手術后患者對兩種不同霧化方式的耐受性,為選擇最佳霧化方式提供參考。方法將49例喉癌手術后患者隨機分為觀察組(25例)和對照組(24例),觀察組采用氧氣霧化吸入,對照組采用空氣壓縮泵霧化吸入。分別記錄兩組患者霧化吸入前及吸入15 min時脈搏血氧飽和度(SpO2)及心率;霧化過程中患者有無心慌、氣緊等不適以及霧化后痰液的性質及量。采用SPSS 13.0軟件進行統計分析。結果兩組患者霧化吸入15 min時的SpO2差異有統計學意義(Plt;001),觀察組高于對照組;而兩組患者霧化吸入前SpO2、心率、不適主訴及霧化后痰液的性質差異均無統計學意義(Pgt;005)。結論氧氣霧化吸入可以提高喉癌手術后患者霧化過程中的SpO2,使患者感覺更加舒適。【Abstract】Objective To investigate postoperative patients with laryngeal carcinoma atomization of two different forms of tolerance, in order to choose the best means of atomization. Methods Fifty postoperative patients with laryngeal carcinoma were divided into observation group using oxygen inhalation and control group using the air compression pump inhalation. Two groups of patients were recorded the value of SpO2 and heart rate before 15 minutes after the inhalation,as well as the discomforts such as flustered,gas tight during the atomization process and the nature and olume of sputum. Results The results of two groups of patients at the time of 15 minutes inhalation SpO2 statistically significant difference (Plt;001), the observation group than in the control group average SpO2 high; and two groups of patients with preinhalation SpO2 average, average heart rate, Discomfort chief complaint and the nature of sputum after aerosol compared no significant difference (Pgt;005). Conclusion Oxygen inhalation in patients with laryngeal cancer can improve the atomization process SpO2 value, so that patients feel more comfortable.
