单次活检切除在喉显微激光治疗早期喉癌中的应用价值

目的探讨单次活检切除在早期喉癌激光治疗中应用的可行性及意义.方法回顾性分析2012年10月至2018年10月82例应用支撑喉镜显微镜下CO2激光手术治疗早期喉癌的临床资料,经活检病理确诊后二次手术切除35例,直接单次手术活检切除或结合术中快速冷冻病理单次手术扩大切除47例.结果两组病例均达良好的局部肿瘤控制率,保留良好的喉功能,肿瘤复发主要与肿瘤分期及浸润深度相关,与两种手术方式的选择并无相关性,但单次手术组在住院时间及费用方面优于分次手术组.结论应用CO2激光喉显微手术治疗早期喉癌,无需术前病理确诊后分次手术,可以结合术中冷冻病理采取单次手术方式切除.部分早期喉癌如术中认为安全边缘足够,整体切除肿瘤后术中切缘的快速冷冻病理并非必需,但术后随访仍非常重要.

Objective To investigate the feasibility and significance of single biopsy in the laser treatment of early laryngeal carcinoma.Methods From October 2012 to October 2018,the clinical data of 82 cases of early laryngeal cancer treated by CO2 laser operarion under self-retaining laryngoscope were analyzed retrospectively,direct single-operation biopsy or extended single-operation combined with intraoperative fast-frozen pathology in 47 cases.Results Both groups achieved good local tumor control rate and retained good laryngeal flinction.Tumor recurrence was mainly related to tumor stage and depth of invasion,but not related to the choice of two surgical methods,however,the length of stay and the cost of single operation group were better than that of single operation group.Conclusion CO2 laser laryngoscopic surgery for early laryngeal cancer can be perfonned in a single operation combined with intraoperative frozen pathology.In some cases of early laryngocarcinoma,if the safe margin is enough,the quick frozen pathology of the resection margin is not necessary,but the follow-up is still very important.