ĐÁNH GIÁ KẾT QUẢ PHƯƠNG PHÁP ĐÓNG HỌNG KIỂU T BẰNG MŨI KHÂU GAMBEE TRONG PHẪU THUẬT CẮT THANH QUẢN TOÀN PHẦN

Abstract

Background: Laryngeal cancers represent a quarter of head and neck cancers, causing 100.000 deaths worldwide. Most of patients come to the clinic at a late stage, requiring total laryngectomy. Throat closure technique is one of the methods to help reduce complications after total laryngectomy. The T-shape closure method has the advantages of simplicity, stabilization, and few complications. Objective: To examine on general, clinical and paraclinical characteristics of patients with laryngeal cancer undergoing total laryngectomy. To evaluate the results of the T-shape closure with Gambee suture technique in total laryngectomy. Method: Uncontrolled clinical intervention study on LR patients treated at ENT Department of Cho Ray Hospital from 03/2019 to 10/2019. Results: Study on 35 patients with mean age of 62.7 ± 7.8, male rate (97.1%) is higher than female. 77.1% of patients both smoked and drank alcohol. Time from symptom onset to hospital admission for more than 6 months accounted for 60%. Patients came to the clinic because of hoarseness accounting for 85%. Histopathology was moderately differentiated squamous cell carcinoma (68.6%). 25.8% of patients were admitted to the hospital when the cancer had progressed to an advanced stage (IVa). T-shaped closure with GAMBEE suture in total laryngectomy with postoperative complications was pharyngeal fistula (8.6%), fluid collection at surgical site (8.6%), bleeding (5.7%), pneumonia (2.9%), and neck flap infection (2.9%). The average time to start oral feeding after surgery was 9.2 ± 6.3 days. The mean hospital stay after surgery was 12.6 ± 2.6 days. None of the patients had tracheostomy stenosis. After 1 month of surgery, no patient had difficulty swallowing. Conclusion: T-shape closure method with Gambee interrupted-suture technique in laryngectomy is highly effective and has few complications.