[1]闫素英,倪鑫,王建宏等.CO2激光在喉肿瘤切除术中的应用[J].中国微创外科杂志,2012,12(6):550-553.
　Yan Suying,Ni Xin,Wang Jianhong,et al.Transoral CO2 Laser Microsurgery for Laryngeal Carcinoma[J].Chinese Journal of Minimally Invasive Surgery,2012,12(6):550-553.
点击复制

CO2激光在喉肿瘤切除术中的应用()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
12
期数:
2012年6期
页码:
550-553
栏目:
出版日期:
2012-06-15

文章信息/Info

Title:
Transoral CO2 Laser Microsurgery for Laryngeal Carcinoma
作者:
闫素英; 倪鑫; 王建宏等
首都医科大学附属北京安贞医院耳鼻咽喉科，北京100029
Author(s):
Yan Suying;  Ni Xin;  Wang Jianhong;  et al.
Department of ENT, Anzhen Hospital, Capital Medical University, Beijing 100029, China
关键词:
CO2激光; 喉肿瘤; 声门型; 声门上型
Keywords:
CO2 laser microsurgery; Laryngeal carcinoma; Glottic; Supraglottic
分类号:
R739.65
文献标志码:
A
摘要:
目的探讨CO2激光治疗喉肿瘤的效果。方法2010年7月~2011年8月对12例早期声门型及声门上型喉鳞状细胞癌，在支撑喉镜下明确病变范围，CO2激光机通过耦合器连接于显微镜，行CO2激光肿瘤切除术。结果手术时间14~33 min，平均18.7 min。术后当日进食。术后3 d内出院。12例随访6~18个月，平均13.4月，术后8个月局部复发1例，术后10个月颈部淋巴结转移1例，声带炎性肉芽肿致呼吸困难1例，声带粘连2例。结论CO2激光治疗T1、T2期声门型及声门上型喉癌能确切切除肿瘤和保留喉功能，无须气管切开和鼻饲，住院时间短，并发症少。
Abstract:
ObjectiveTo determine the role of transoral CO2 laser resection in laryngeal carcinomas. MethodsThe clinical data of 12 patients with early laryngeal tumors, whose pathological results showed glottic and supraglottic squamous cancer during July 2010 to August 2011, were retrospectively analyzed. After ascertaining the extent of the tumor with selfretaining laryngoscope, a CO2 laser machine was connected to the microscope by a coupler to remove the tumor.ResultsThe operation time ranged from 14 to 33 minutes with a mean of 18.7 minutes. All the patients had normal diet on the day after the operation, and then were discharged from hospital in three days. The patients were followed up for 6 to 18 months with a mean of 13.4 months. One of them had local recurrence in 8 months, one patients showed metastasis to the neck lymph nodes in 10 months, one patient developed expiratory dyspnea because of inflammatory granuloma, and two patients showed vocal cords adhesion at the anterior commissure.ConclusionAs the first choice for T1/T2 glottic and supraglottic carcinoma, transoral CO2 laser can excise tumor correctly with the larynx being preserved, without needing tracheotomy or nasal feeding. It shortens hospital stays and reduces complications.

参考文献/References:

[1]Hinni ML, Salassa JR, Grant DG, et al. Transoral laser microsurgery for advanced laryngeal cancer. Arch Otolaryngol Head Neck Surg,2007,133:1198-1204.
[2]Osborn HA, Hu A, Venkatesan V, et al. Comparison of endoscopic laser resection versus radiation therapy for the treatment of early glottic carcinoma. J Otolaryngol Head Neck Surg,2011,40(3):200-204.
[3]Remacle M，Eckel HE，Antonelli A，et al．Endoscopic ordectomy. A proposal for a classification by the Working Committee，European Laryngological Society． Eur Arch Otorhinolaryngol，2000,257：227-231．
[4]Remacle M, Hantzakos A, Eckel H, et al. Endoscopic supraglottic laryngectomy. A proposal for a classification by the working committee on nomenclature, European Laryngological Society. Eur Arch Otorhinolaryngol,2009,266:993-998.
[5]黄志刚,韩德民,于振坤,等.CO2激光手术治疗声门型喉癌疗效分析.中华耳鼻咽喉科杂志,2002,37(3):219-222.
[6]Hsin LJ,Fang TJ,Chang KP,et al．Transoral endoscopic CO2 laser microsurgery for early laryngeal cancers. Chang Gung Med,2009,32(5):517-525.
[7]Bradley PJ, Rinaldo A, Sua′rez C, et al. Primary treatment of the anterior vocal commissure squamous carcinoma. Eur Arch Otorhinolaryngol,2006,263:879-888.
[8]Ralph M, Steiner W, Roland M, et al. Endoscopic laser surgery of early glottic cancer: involvement of the anterior commissure .Head & Neck,2009,(5):583-592.
[9]Csanády M, Czigner J, Vass G, et al. Transoral CO2 laser management for selected supraglottic tumors and neck dissection. Eur Arch Otorhinolaryngol,2011,268(8):1181-1186.
[10]黄志刚,韩德民,倪鑫,等.CO2激光手术治疗声门上型喉癌.中华耳鼻咽喉科杂志,2008,43(10):738-741.
[11]Blanch JL, Vilaseca I, BernalSprekelsen M, et al. Prognostic significance of surgical margins in transoral CO2 laser microsurgery for T1-T4 pharyngolaryngeal cancers. Eur Arch Otorhinolaryngol,2007,264:1045-1051.
[12]吴娇娇,黄志刚,房居高,等.C02激光手术治疗喉癌的并发症分析.中华耳鼻咽喉头颈外科杂志,2011,46(2):118-122.
[13]蔡红武,唐安洲,徐志文,等.喉C02激光手术后声带粘连原因分析.临床耳鼻咽喉头颈外科杂志,2010,24(4):147-151.

更新日期/Last Update: 2012-06-15