Diomed-25半导体激光手术治疗早期声门癌疗效观察

Evaluate the effect of Diomed-25 laser in treatment of early vocal cord carcinoma

目的 :观察激光治疗早期声门癌的临床效果。方法 :采用Diomed 2 5半导体激光器对18例早期声门癌患者进行手术治疗 ,其中 7例在局麻下进行 ,10例在全麻下进行 ,1例患者局麻下难以配合 ,全麻支撑喉镜下前联合暴露困难 ,遂行喉裂开后以激光切除肿瘤。结果 :术后随访 3～ 5年 ,局部复发 3例 ,其中 2例为T1b患者 ,病变侵犯前联合 ,1例为T2 病变。 18例中 ,失访 1例 (按死亡计算 ) ,3年生存率为 10 0 .0 % (18/18) ,5年生存率为 90 .9% (10 /11)。除 2例肿瘤复发行全喉切除外 ,余 16例均保留了喉发声功能。结论 :半导体激光手术治疗早期声门癌 ,疗效确切 ,喉功能保留好 ,并发症发生率低 ,有临床应用价值。

Objective:To observe the effect of Diomed 25 laser in treatment of early vocal cord carcinoma.Method:Eighteen cases of early vocal cord carcinoma were treated by laser surgery. Among the cases, 7 were under local anesthesia, and 10 were under general anesthesia.1 case was operated laryngofissure due to failure of tumor exposure.Result:The follow up period was from 3 to 5 years. Relapse were detected in 3 out of 18 cases of early vocal cord carcinoma after Diomed laser surgery under fiber or self retaining laryngoscope. Of the recurrent cases, 2 T 1b tumors offended the anterior commissure, another was T 2 case. 1 failed to be followed up (taken into dead), 3 year survival rate was 100.0% (18/18), 5 year survival rate was 90.9 % (10/11). Except 2 cases receiving total laryngectomy, the others had their laryngeal function reserved.Conclusion:It has clinical value to use Diomed 25 laser in treatment of early vocal cord carcinoma,and its advantages include lower complication rate and laryngeal function well retained.