Vanchenko V. Peculiaritites of organ-saving and reconstructive operations for laryngeal cancer T3N0M0 in the elderly

Conducted was a retrospective analysis of case histories of 198 patients that were treated for laryngeal cancer T3N0M0 from 1976 to 1995. It was found out that in all phases of combined treatment, complications (suppurative, inflammatory, post-radiation therapy) were occurring 2-4 times more frequently in the elderly patients as compared to younger patients with the same stage of the disease. Complications were more severe and refractory to medication treatment. The leading remote post-operative complication after organ-saving surgeries for cancer of the larynx T3N0M0 in elderly patients was decompensation of separating biomechanism of the larynx with the rate exceeding 80% of surgical treatment failures. Increasing the degree of tissue radioprotection in irradiated areas not only significantly decreased morbidity and depth of post-radiation therapy complications, but also provided for good level of oxygen saturation of surrounding tissues. Soft scarring and adequate healing of the post-operative woundwas achieved due to better conditions of adaptation and regulatory capabilities of the body. As a result, the rate of early and remote complications of the organ-saving treatment in elderly patients with laryngeal cancer T3N0M0 was decreased. Developed was the technique of subtotal larynx resection, the distinguishing feature of which was primary laryngoplasty in the pre-last stage of the intervention: employing the mucosal fold of the hypopharynx, the artificial "roof" of the resected larynx was formed, that partially covered laryngeal aperture and protected respiratory tract from fluids and food getting into it during swallowing.