喉頭癌手術後の再發豫防上の重點

　九大耳鼻臨床に於て昭和11年以来今日迄に喉頭全摘出術を行つた喉頭癌患者は200例でこのうち現在迄に再発を来したものは70例（35％であり，5年治癒率は約60％である。

　之等の再発例を部位によつて分けると次の4群に大別する事が出来る。

　第1群：頸リンパ節に再発したもの46例

　第2群：舌根部，下咽頭又は食道入口部に再発したもの10例

　第3群：気管断端附近に再発したもの11例

　第4群：遠隔臓器（肺，肝，肋骨）に転移を来したもの3例

IWAMOTO finds that, since 1936 to date, the number of patients operated upon by total laryngectomy for cancer, at the OtolaryngoIo-gical Department of The Kyushu University, aggregated to 200 cases. Of this number re-currence of the disease as metastasis is seen in 70 cases; of which 40 in the cervical lymph glands; 10 at the root of the tongue, subglo-ttic region or upper end of esophagus; 11 at the amputated end of trachea; 3 in various internal organs. In order to prevent these recurrence the author suggests observation of following impotant points during the time of operation: 1) A radical neck dissection for a complete removal of lymphglands should ensue the operation if cervical involvement is found to be established; but,even when this involve-ment is not evident such a procedure is ne-cessary should the cancer be deemed a type that whould be likely to cause metastsis later.

2) A care should be taken to keep pre-epiglottic space intact and without injury while the hyoid bone be removed en toto witle the larynx; a procedure which may prevent later involvement of the root of the tongue, subglottic region and the upper end of esophagus.

3) Any lymph glands in proximity of the larynx should be meticulously removed which will include also the thyroids, partially or to-tally as the case may be, depending upon the degree in which they may appear to be invol-ved. Such a procedure may prevent later involvement of the amputated end of trachea.