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[喉的阿克曼肿瘤:二氧化碳激光手术的结果]

[Ackerman's tumors of the larynx: results of CO2 laser surgery].

作者信息

Damm M, Jungehülsing M, Sittel C, Eckel H E

机构信息

Hals-Nasen-Ohrenklinik und Poliklinik, Universität zu Köln.

出版信息

Laryngorhinootologie. 2000 Oct;79(10):565-72. doi: 10.1055/s-2000-7677.

Abstract

BACKGROUND

Ackerman's tumor, named after the author of the first description in 1948, is a low grade malignant tumor. The aim of this paper is to clarify the role of the carbon dioxide laser therapy in the management of this neoplastic disorder of the larynx.

PATIENTS

Twenty-four men and one woman suffering from glottic tumors fulfilled the diagnostic criteria laid down by Ackerman from 1986 to 1998. All patients were treated with transoral laser surgery with a follow-up ranged from 14 to 142 months.

RESULTS

Seventeen patients were diagnosed at T1, seven at T2, and one at T3. In T1 lesions, a laser cordectomy or an extended laser cordectomy was performed. In T2 and T3 tumors, partial laryngectomy with a CO2 laser was performed. No patient died tumor-related. In this series, initial failure rate of laser resection was 8%: one patient was salvaged with endolaryngeal laser surgery, another patient (initially T3 tumor) with total laryngectomy. No patient required radiation therapy. No cases of anaplastic transformation were recognized.

CONCLUSIONS

Based on this material, recommended treatment for T1 and T2 Ackerman-Tumors is oncologic CO2 laser resection in combination with a meticulous follow up for every recognition of local recurrences.

摘要

背景

阿克曼肿瘤是以1948年首次描述该肿瘤的作者命名的,是一种低级别恶性肿瘤。本文旨在阐明二氧化碳激光治疗在这种喉部肿瘤性疾病管理中的作用。

患者

1986年至1998年期间,24名男性和1名女性患有声门肿瘤,符合阿克曼制定的诊断标准。所有患者均接受经口激光手术治疗,随访时间为14至142个月。

结果

17例患者诊断为T1期,7例为T2期,1例为T3期。对于T1期病变,进行了激光声带切除术或扩大激光声带切除术。对于T2期和T3期肿瘤,采用二氧化碳激光进行部分喉切除术。没有患者因肿瘤相关原因死亡。在本系列中,激光切除的初始失败率为8%:1例患者通过喉内激光手术挽救,另1例患者(最初为T3期肿瘤)进行了全喉切除术。没有患者需要放疗。未发现间变转化病例。

结论

基于该材料,对于T1期和T2期阿克曼肿瘤,推荐的治疗方法是进行肿瘤性二氧化碳激光切除,并对每一次局部复发的识别进行细致的随访。

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