支撑喉内镜下咽喉部微创手术的临床应用

Clinical application of laryngeal endoscopy in the minimally invasive surgery of laryngeal diseases

目的 :探讨支撑喉内镜系统手术治疗咽喉部疾病的临床应用价值 ,进一步改进咽喉部微创手术方式。方法 :全麻下采用支撑喉内镜系统微创手术治疗 34例咽喉疾病患者 ,术中微波等处理残灶及出血区 ;恶性肿瘤术后行 4 0Gy放疗。结果 :本组 34例患者均一次手术成功 ,随访 1～16个月 ,未见严重手术并发症 ;术前已发生声嘶的 2 6例良性病变者术后 1个月内发声恢复正常 ;2例早期声带癌术中保留喉结构和功能 ,随诊 6～ 12个月未见肿瘤复发 ,声嘶明显好转。 结论 :支撑喉内镜微创手术治疗咽喉部良性病变、早期声带癌及癌前期病变具有重要价值 ,该项技术具有视野大、清晰度高、照明度好、切除病变彻底、保留结构功能好等优点 ,值得临床推广应用。

Objective:To study the value of laryngeal endoscopic system in the treatment of laryngeal diseases with minimally invasive surgery.Method:This paper was to summarized retrospectively the clinical experience of 34 cases suffered from laryngeal diseases treated by minimally invasive surgery with laryngeal endoscopic system. The remain tumor and hemorrhage were treated by microwave machine. The malignant tumors were treated by radiotherapy with 60 Co in 40 Gy, postoperatively.Result:The tumors were totally resected and no serious complications were revealed. Followed-up these 34 cases, 26 cases with benign pathological changes who had hoarseness preoperatively recovered to normal 1-month after operation. In 2 cases with vocal cord carcinoma at the early stage, the functions and construction of throat were retained and no recurrence was founded after 6-12 month postoperatively.Conclusion:The laryngeal endoscopic system is valuable in treating laryngeal pathological regions and early stage carcinoma for its minimally invasion, wide operative field, good illuminative degree and normal construction and function reserved.