早期喉恶性肿瘤的CO_2激光微创治疗

Laser micro-traumatic surgery for treatment of early glottic carcinoma and laryngeal precancerous lesions

目的 探讨支撑喉镜显微镜下CO2 激光治疗早期喉恶性肿瘤的疗效。 方法 经术前病理诊断和术后病理证实的 9例早期声门癌 (T1N0 M0 )及 17例喉白斑 ,于全麻下在支撑喉镜显微镜下行 3种类型激光声带术治疗 ,并对疗效进行随访。 结果 经平均 15个月的随访 ,2 6例中除开展此术初期的 2例喉白斑因阴性切缘不足分别于术后 3月和 5月复发而重行激光术外 ,其余病例无并发症及复发征象 ,发音功能恢复良好。 结论 支撑喉镜显微镜下CO2 激光声带术是对早期喉恶性肿瘤行之有效的微创手术 ,既能根治肿瘤 ,又能保持发音质量。

Objective To investigate the clinical effectiveness of the endoscopic and microscopic laser surgery for managing early glottic carcinoma and laryngeal precancerous lesions. Methods Nine patients with stage I glottic carcinoma (T 1N 0M 0) and seventeen patients with laryngeal precancerous lesions were operated under endoscope and microscope with CO 2 laser. All the cases were diagnosed pathologically, and the preformed operations could be differentiated to three patterns, namely Type Ⅰ,Ⅱ and Ⅲ. Results Data of follow up for average 15 months showed that excellent local control was achieved in all the cases with the exception of two cases of laryngeal keratosis. These two recurred 3 and 5 months after operation respectively and treated with laser surgery again. It was at least indicated that short term effect of the treatment is satisfying. Conclusions It is effective and micro traumatic to treat early glottic carcinoma and laryngeal precancerous lesions with endoscopic and microscopic laser surgery. Such operation could not only ablate the cancer radically, but also improve the postoperative voice quality.