CO_2激光显微手术治疗喉癌前病变的疗效分析

Efficacy evaluation of carbondioxide laser in the treatment of laryngeal precancerous lesions

目的评价二氧化碳(CO_2)激光治疗喉部癌前病变的临床疗效,并探讨相关手术处理技巧。方法选取喉部良性(癌前)病变患者22例,均在喉镜显微镜下以CO_2激光切除喉部病变,观察患者术后并发症发生情况及术后恢复情况。结果所有患者手术均一次成功,术中未出现任何并发症。术后随访6个月～1年,其中2例双侧声带乳头状瘤患者因病变累及前联合分别于术后3个月、10个月复发,行二氧化碳激光再次切除后,其中一例至末次随访未再复发。一例再行二氧化碳激光切除后再次复发癌变,行额侧喉部分切除。两例患者因病变累及前联合分别于术后1-2个月出现声带黏连。所有患者术后未出现呼吸困难、出血等并发症发生。结论 CO_2激光治疗喉部癌前病变既可彻底切除病变,又可保留喉部结构,且复发患者可重复手术,从而使喉部功能及发声得以良好保留,可作为喉部癌前病变的有效治疗方式。

Objective To evaluate the clinical efficacy of carbon dioxide(CO2)laser in the treatment of laryngeal precancerous lesions and discuss the relevant surgical techniques.Methods Twenty-two patients with benign laryngeal(precancerous)lesions were selected and all the laryngeal lesions were removed by CO2laser under laryngoscope.The postoperative complications and postoperative recovery were observed.Result All patients had a successful operation and no complications occurred during the operation.During the follow-up period of6months to1year,2patients with bilateral vocal cord papilloma recurred at3months and10months after the onset of the lesion and were treated with a CO2laser reoperation.One of them did not relapse;One case had recurrence of cancer and resection of the frontolateral larynx.Two patients had vocal cord adhesions1-2months after surgery due to lesion involvement.All patients had no postoperative complications such as dyspnea and bleeding.Conclusion Carbon dioxide laser treatment of laryngeal precancerous lesions could completely remove the lesions and preserve the laryngeal structure,and patients with recurrence could repeat the operation,so that the function and vocalization of the larynx could be well preserved,which could be used as an effective treatment for precancerous lesions of the larynx.