碘染色在早期声门型喉癌经口激光显微手术中的应用

Application of iodine staining in transoral laser microsurgery for early glottic carcinoma

目的:探讨碘染色在早期声门型喉癌经口激光显微手术中切缘判定的应用价值。方法:2016-01-2017-12纳入研究的早期声门型喉癌(Tis-T2)患者35例,全身麻醉后用1.5%Lugol碘溶液涂布声带3遍,手术显微镜下观察喉腔着色情况,以辅助判定病变范围。以CO2激光整块切除病变。评价并发症发生率、病灶完整切除率、复发率。结果:35例患者在经口激光显微手术中使用了碘染色辅助判断病变范围。无一例患者发生并发症。术后病理结果显示病灶的完整切除率为88.6%。Tis和T1a无局部复发病例,T1b局部复发率为12.5%,T2局部复发率为16.7%,总体局部复发率为5.7%。结论:在早期声门型喉癌经口激光显微手术中应用碘染色有助于提高完整切除率和局部控制率,是一种可靠、简单、成本低廉的方法,值得临床推广应用。

Objective:To evaluate the value of iodine staining in the margin determination in transoral laser microsurgery for early glottic carcinoma.Method:35 patients with early glottic laryngeal cancer(Tis-T2)were enrolled in this study from January 2016 to December 2017.All patients were applied with 1.5%Lugol iodine solution to vocal cords for 3 times after general anesthesia,and the coloration of the laryngeal cavity was observed under the operation microscope to determine the lesion margins.The lesions were excised completely with CO2 laser.The complications,complete resection rate and recurrence rate were evaluated.Result:In all patients,iodine staining was used to assist in determining the lesion range during transoral laser microsurgery.None of the patients had complications.Postoperative pathological results showed that the complete resection rate was 88.6%.There were no local recurrence cases in Tis and T1 a,while local recurrence rate was 12.5%in T1 b and 16.7%in T2,respectively.The overall local recurrence rate was 5.7%.Conclusion:The application of iodine staining in transoral laser microsurgery for early glottic carcinoma may help improve the complete resection rate and local control rate.It is a reliable,simple and low-cost method,worthy of further clinical application.