Сравнительная характеристика методик формирования глоточно-пищеводного анастомоза и бесканюльной трахеостомы у ларингэктомированных пациентов

Abstract

Radical treatment of laryngeal cancer allows achieving good oncological results but leads to disability of patients. Restoration of voice function after laryngectomy is the main aspect of rehabilitation. The improvement of existing methods of pharyngeal reconstruction contributes to the creation of favorable conditions for subsequent rehabilitation. Objective. Improving the effectiveness of the results of the surgical stage of complex rehabilitation of laryngectomized patients. Materials and methods. The results of surgical treatment were analyzed in 70 patients diagnosed with stage III–IV laryngeal cancer. Patients were divided into 2 groups depending on the technique of suturing the pharynx and the formation of a tubeless tracheostomy. Results. The developed technique of pharyngeal reconstruction with simultaneous formation of anatomical and physiological prerequisites for early rehabilitation of patients after laryngectomy does not increase the total operation time and averages 25–30 minutes in 68.57% of cases, reduces the likelihood of complications in the postoperative period by 11.41%, reduces the incidence of scarring deformities of the pharyngeal-esophageal funnel by 11.43%, allows achieving the formation of a tubeless tracheostomy resistant to narrowing in 74.27%, and does not affect the oncological effectiveness of combined treatment of patients with stage III–IV laryngeal cancer. Conclusion. The developed method of closing the pharyngeal defect after laryngectomy showed high effectiveness and allowed improving the results of postoperative wound healing, reducing the number of local postoperative complications as well as improving functional results.