250 KB10 KB199220251999Balatoni, ZsuzsaElo, JanosKotai, Zsuzsaštevilka:2letnik:33str. 159-162ISSN:1318-2099COBISSID_HOST:9974489URN:URN:NBN:SI:doc-Z4HIB3U9enCroatian Medical Association - Croatian Society of RadiologySlovenian Medical Society - Section of RadiologyRadiology and oncology (Ljubljana)LaryngectomyLarynxMethodsNeoplasm stagingOropharyngeal neoplasmsRadical neck dissectionRetrospective studiesSurgerySurgical flapsTreatment outcomeSurgical treatment of advanced oropharyngeal cancer with preservation of the larynx| Kirurško zdravljenje raka na orofarinksu z ohranjenim larinksom|Background and methods. This retrospective study evaluates the oncological andfunctional results obtained in 61 patients with advanced oropharyngeal cancer who underwent extended tumor resection as a primary procedure or as a salvage surgery form. Results. Although the oropharyngeal cancers involved thebase of the tongue, or some of them extended to the lateral hypopharyngeal wall, the surgery was performed without total laryngectomy. The tumor extendedto the vallecula and/or to the pharyngoepiglottic fold in five cases, which required supraglottic laryngectomy. The closure following the extended resection of the tumor was made with flap reconstruction in all patients. The preferred method was employing the pectoralis major myocutaneus flap. The survival rates were 75%, at 1 year and 31 %, at 2 years and 25% from 2 to 5 years with recurrence of the disease. In one patient, the nasogastric tube could not have been removed, and another patient could be decannulated only after postoperative radiation because of the persistent oedema. Conclusions. Asatisfactory functional result was obtained in this series. In most of our patients, good functioning of larynx as well as voice preservation were securedIzhodišča in metode. V retrospektivni raziskavi smo poskušali z onkološkega infunkcionlanega vidika oceniti rezultate zdravljenja 61 bolnikov z napredovalim rakom na orofarinksu, ki so že prestali razširjeno resekcijo tumorja kot primarno zdravljenje ali pa kot reševalno terapijo. Rezultati. Čeprav je večina rakov na orofarinksu zajemala tudi koren jezika ali se je razširila do stranske stene hipofarinksa, nismo naredili totalne laringektomije. V 5 primerih se je tumor vrasel v območje epiglotisne valekuleali faringoepiglotisa, zato je bila potrebna supraglotisna laringektomija. Po obsežni resekciji tumorja smo pri vseh bolnikih opravili rekonstrukcijo z režnjem, pri kateri smo najbolj pogosto uporabili reženj velike pektoralne mišice. Preživetje je bilo po 1 letu 75%, v času od 2 do 5 let pa je znašalo 31%, vendar s precej pogosto zgodnjo ponovitvijo bolezni. Pri enem bolniku nismo mogli odstraniti nazogastrične sonde, drugemu pa smo zaradi obsežnega in trdovratnega edema lahko odstranili kanilo šele po pooperativnem obsevanju. Zaključki. V tej seriji bolnikov smo glede funkcionalnosti dosegli zadovoljive rezultate. V večini primerov smo pri bolnikih ohranili funkcionalnost farinksa in sposobnost govoraTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaOnkološki inštitut Ljubljana