早期声门型喉癌的CO_2激光手术治疗

Clinical reseach of early laryngocarcinoma treatment by carbon dioxide laser microsurgery

目的：探讨CO2激光手术治疗声门型喉癌的临床治疗效果。方法：112例声门型喉癌患者均在全身麻醉下经口气管插管,用支撑喉镜充分暴露声门,完全看清肿瘤后,显微镜下用CO2激光沿肿瘤外缘切除声门肿瘤,安全边界为3~5mm。术后随诊12~62个月。结果：112例支撑喉镜下CO2激光手术后8例局部复发,局部复发率7.14%,T1a复发率0.89%、T1b复发率0.89%、T2复发率5.40%,组间差异有统计学意义（χ2=5.306,P〈0.01）。病变侵犯前连合复发率7.14%,病变未侵犯前连合复发率7.14%,2组差异无统计学意义（χ2=0.000,P〉0.01）。1例患者术后当天出现喉腔大出血,经再次手术,应用带吸引单极电凝止血成功。结论：激光手术治疗早期声门型喉癌疗效可靠,喉功能保全好,是早期喉癌较为理想的治疗方式。

Objective：To define the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carcinoma.Method：A retrospective study of 112patients with laryngocarcinoma treated.Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society.After the patients were given thegeneral anesthesia and oral intubation,the tumors in the study group were resected along the margin of the tumor under larynscope,and the safety margin was reserved as 3-5mm.All the patients were followed-up for 12-62 months.Result：Eight relapses were detected in 112cases of glottic laryngeal carcinoma after CO2 laser surgery.The local recurernce rate was 7.14%（8/112）,of the rate for T1a,T1b and T2 were 0.89%,0.89% and 5.40%respectively, with significant differences among groups（χ2=5.306,P〈0.01）.The rate of local recurrence rate of anterior commissure involvement was 7.14%and that was 7.14% when this site was not compromised by the tumor,which has no statistically significant differences（χ2=0.000,P〉0.01）.Conclusion：According to our reaserch,endoscopic CO2 laser surgery is an effective treatment for early laryngocarcinoma.