[Total laryngectomy in advanced stage laryngeal carcinoma].
OBJECTIVE
To summarize the effects of total laryngectomy in advanced stage laryngeal carcinoma in the fourteen years in our hospital.


METHODS
Five hundred and seventy-three patients with laryngeal carcinoma who underwent total laryngectomy were studied retrospectively. Among them 143 cases underwent total laryngectomy and the other 430 cases underwent simultaneous neck dissection, 239 cases ipsilateral and 191 cases bilateral. Enlarged tracheal fistula was applied in 308 cases from 1989.


RESULTS
Three, five and ten year survival rates were 69.5%, 61.1% and 46.3% respectively. Among 220 patients who died during follow up, 45.0% died from local recurrence and 22.3% died from cervical lymph node metastasis. Local infection and pharyngeal fistula rate were 12.2% and 5.2% respectively. 16.6% patients who underwent enlarged tracheal fistula needed secondary operation or wearing cannula because of narrowed fistula. Partial laryngectomy could be applied to 13.6% patients but total laryngectomy was done to those patients because of different reasons.


CONCLUSIONS
Total laryngectomy is still a major treatment in advanced stage laryngeal carcinoma but its indications are decreasing gradually with the development of surgical technique. Although positive attitude of neck dissection was taken, local recurrence was the main reason of death.
Liu
Bin
B
Department of Otorhinolaryngology, the First Affiliated Hospital of China Medical University, Shenyang. liubincmu@163.com
Pan
Zimin
Z
Ji
Wenyue
W
D000328:Adult; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies