Author/Editor		Aničin, Aleksandar; Šmid, Lojze
Title		Ohranitvena kirurgija grla po obsevalnem zdravljenju
Translated title		Partial laryngectomy in the treatment of radiation failure
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 43, št. Suppl 3
Publication year		2004
Volume		str. 265-8
Language		slo
Abstract		A series of 14 patients was reviewed who had been treated with conservation surgery of the laryrnx for radiotherapy failure of early glottic squamous cell carcinoma between 1982 and 1999 at the Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre, Ljubljana, Slovenia. The median disease-free interval prior to surgery was 9.5 months. Selection of the surgical procedure was based on tumour size at the time of surgery. Cordectomy was performed in six patients, and three had extended cordectomy, four vertical frontolateral laryngectomy and one endoscopic laser cordectomy. In two patients, healing was delayed because of infection, and one of them had a laryngocutaneous fistula. Local recurrence developed in 21.5% of cases, and 93% of all patients (13/14) were cured with additional salvage laryngectomy. Partial laryngectomy after failed irradiation of early glottic carcinoma provides good local control and voice preservation and is the cornerstone of successful treatment, along with early diagnosis and appropriate patient selection.
Summary		V raziskavi smo ovrednotili rezultate ohranitvene kirurgije grla po neuspešni radioterapiji začetnega ploščatoceličnega karcinoma glasilk 14 bolnikov, zdravljenih od 1982 do 1999, na Kliniki za otorinolaringologijo in cervikofacialno kirurgijo Kliničnega centra v Ljubljani. Mediani čas, ki je potekel od zaključka radioterapije do ohranitvene operacije grla, je bil v naši študiji 9,5 mesecev. 0 vrsti kirurškega posega smo se odločali glede na razsežnost primarnega tumorja v času operacije. Pri šestih bolnikih smo naredili hordektomijo, pri treh razširjeno hordektomijo, pri štirih vertikalno frontolateralno laringektomijo in pri enem endoskopsko lasersko hordektomijo. Po operaciji je pri dveh bolnikih prišlo do vnetja rane, vključno tudi z larigokutano fistulo pri enem. Do lokalne ponovitve bolezni je v naši študiji prišlo v 21,5% (3/14), z dodatno laringektomijo pa smo ozdravili skupno 93% bolnikov (13/14). Delna odstranitev grla po predhodni neuspeli radioterapiji začetnih karcinomov glotisa poleg dobrega preživetja brez lokalne ponovitve bolezni omogoča tudi ohranitev glasu in temelji na zgodnji diagnostiki s pravilno izbiro bolnikov.
Descriptors		LARYNGEAL NEOPLASMS CARCINOMA, SQUAMOUS CELL GLOTTIS LARYNGECTOMY TREATMENT OUTCOME