支撑喉内镜联合喉吸切割系统在喉微创手术中的应用观察

Combined laryngeal minimal invasive surgery with laryngeal suctioncutting system under self-retaining laryngoscope to remove laryngeal benign proliferating lesions

目的：观察支撑喉内镜联合喉吸切割动力系统在喉良性增生性病变切除术中的应用效果。方法回顾性分析2009年12月～2013年8月本院在支撑喉内镜下联合使用美敦力喉吸切割动力系统完成的喉良性增生性病变切除术178例，总结其应用效果。所有患者于术后均适当禁声，并予以雾化吸入及中药甘桔冰梅片口服等综合治疗。结果本术式操作简便，视野清晰精确，所有手术均一次成功，治愈率高达95.5%，仅1例声带白斑患者2个月后出现病变复发并发生癌变，改行一侧声带激光切除术，其他均痊愈。结论支撑喉内镜联合喉吸切割系统切除喉的良性增生性病变，具有视野清晰、无盲区、操作便捷、精确度高、并发症少、疗效肯定等优点，值得临床推广。

Objective To sum up clinical experience with the application of combined minimal invasive laryngeal surgical procedures with laryngeal suction-cutting system under self-retaining laryngoscope to remove laryngeal benign proliferating lesions.Methods A retrospective analysis was carried out among 178 cases with laryngeal benign proliferating lesions treated by a minimal invasive laryngeal surgery combined Medtronic laryngeal suction-cutting system and self-retaining laryngoscope in our Hospital from Dec. 2009 to Aug. 2013, supplemented with a routine postoperative therapy composed of such measures as reasonably prohibiting vocalization, anti-inflammatory drugs inhaling by means of atomization, herbal preparation Ganjubingmei Tablets orally taking and so on. Their clinical data was carefully analyzed to sum up our experience with such a surgical procedure based on the clinical outcome of this group of cases after a period of following up period.Results The operation was simple to perform and the vision field of operating was very clear, with the surgery successful on once time and total curative rate as high as 95.5%, other than one case, who was diagnosed as vocal cord leukoplakia at first and found the lesion being canceration 2 months latter following the operation, being treated by laser resection of the diseased vocal cord then as a salvage procedure. Other patients were all cured without their condition relapsed.Conclusions This kind of combined minimal invasive laryngeal surgery with laryngeal suction-cutting system performed under self-retaining laryngoscope can surgically treat laryngeal benign proliferating lesions with such advantages as vision clear with no blind operating area, convenient to perform, high precision during operating, less complications following the operation and definitive therapeutic effect as seen from the clinical outcome. Therefore, it is worthy of to put it into a winder range of utilizing in clinical practice.