CO_2激光治疗声门型喉癌远期疗效分析

Long-term curative effect of CO_2 laser surgery for glottic laryngeal carcinoma

目的探讨显微支撑喉镜下CO_2激光治疗声门型喉癌的远期治疗效果。方法对声门型喉癌患者106例,采用显微支撑喉镜下CO_2激光治疗,回顾性分析病历资料。其中T_(is)N_0M_04例、T_(1a)N_0M_062例、T_(1b)N_0M_016例、T_2N_0M_022例、T_3N_0M_02例。结果 106例患者手术顺利,无严重并发症发生。术后死于复发或颈部转移4例,死于意外4例,死于远处转移2例,失访4例,术后局部复发者再次手术后至今良好2例。目前92例仍存活,无肿瘤复发,生活质量良好。3年、5年和10年生存率分别为98.7%、95.2%和89.0%,总局部复发率为5.7%。结论显微支撑喉镜下CO_2激光手术是治疗T_(is)、T_(1a)声门型喉癌的首选方法,手术创伤小,术后恢复快,喉功能保全好,远期生存率高;该手术对于经过精心选择的声门型T_(1b)和T_2、T_3喉癌也有较好的临床疗效。

Objective To evaluate the long-term curative effect of CO2 laser surgery for glottic laryngeal carcinoma un-der microscopic suspension laryngoscope.Methods Clinical data of 106 cases of glottic laryngeal carcinoma were ret-rospectively analyzed,including 4 cases of Tis N0 M0 ,62 cases of T1a N0 M0 ,16 cases of T1b N0 M0 ,22 cases of T2 N0 M0 ,and 2 cases of T3 N0 M0 .All cases were treated with microscopic suspension laryngoscope CO2 laser surgery during 2004 and 2015.Results All operations were successful without serious complications.Of all 106 cases,4 died of recurrence,4 died of accidents,2 died of distant metastases,4 failed to be followed up,and 2 received a second op-eration due to recurrence and survived well.A total 92 patients were still alive without recurrence,with good quality of life.The 3,5 and 10-year survival rate were respectively 98.7%,95.2% and 89.0%.The local recurrence rate was 5.7%.Conclusion Microscopic suspension laryngoscope CO2 laser surgery is the preferred method for glottic larynge-al carcinoma Tis and T1a ,which produces few surgical trauma,fast postoperative recovery,good laryngeal function preservation and high long-term survival rate.This operation method also has good clinical effect for selected cases of glottic laryngeal carcinoma T1b ,T2 and T3 .