经口机器人手术治疗喉下咽食管入口孤立性纤维性肿瘤1例并文献复习

Transoral robotic surgery in the management of solitary fibrous tumor at the entrance of the hypolaryngeal esophagus:a case report and literature review

探讨发生于喉、下咽及食管入口范围较广孤立性纤维性肿瘤(solitary fibrotic tumor,SFT)的临床诊治经验。分析空军军医大学唐都医院耳鼻咽喉头颈外科收治的1例女性患者(78岁),原发于喉、下咽、食管入口的SFT患者的临床资料、手术方式及病理组织学特征,并复习相关文献。患者喉、下咽、食管入口处有大小约3.8 cm×2.8 cm×2.0 cm表面光滑肿物,遮挡喉前庭、声门及右侧梨状窝,经口达芬奇机器人完整切除肿瘤,并同时缝合修复下咽创面,术后病理诊断为SFT。患者术后恢复良好,随访16个月未见复发。结论:发生于喉、下咽、食管入口的SFT非常少见,经口达芬奇机器人手术切除该部位的肿瘤是可行的,而且具有视野清晰、出血少、创伤小、并发症少、术后恢复快等优点。

To explore the clinical diagnosis and treatment experience of isolated fibrotic tumor(SFT) occurring in the larynx,hypopharynx and esophageal inlet with a wide range.The patient,admitted to the Department of Otolaryngology-Head and Neck Surgery of Tangdu Hospital of Air Force Medical University was a female aged at 78 years,who was diagnosed with SFT primarily occured at laryngeal,hypopharynx and esophageal entrance.The clinical data,surgical methods,histopathology characteristics of the patient were analyzed respectively.It's proved that a tumor sized about 3.8 cm×2.8 cm×2.0 cm with slippy surface was found at the entrance of the laryngeal,hypopharynx and esophageal entrance,covering the laryngeal vestibule,glottis and right piriform fossa,which was completely resected by transoral robotic surgery.The postoperative pathological diagnosis was SFT.The patient recovered well after surgery and showed no recurrence within 16-month follow-up.SFT occurring in the larynx,hypopharynx,and esophageal inlet is very rare,and transoral da Vinci robotic surgical resection of the tumor in this area is feasible,and has the advantages of clear field of vision,less bleeding,less trauma,fewer complications,and quicker postoperative recovery.