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老年喉癌患者二氧化碳激光手术后的并发症

Complications after CO(2) laser surgery of laryngeal cancer in the elderly.

作者信息

Sesterhenn Andreas M, Dünne Anja A, Werner Jochen A

机构信息

Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Germany.

出版信息

Acta Otolaryngol. 2006 May;126(5):530-5. doi: 10.1080/00016480500417064.

Abstract

CONCLUSION

Cancer of the larynx in elderly patients should be treated with curative intention, if the extension of the primary tumour allows safe resection. Transoral CO(2) laser microsurgery is associated with a low rate of major complications and can be regarded as suitable even for elderly patients. Age itself should never be the sole factor in deciding which therapy should be undertaken.

OBJECTIVES

In the industrialized nations the age group beyond 75 years will grow steadily, requiring special attention by medical professionals in the future. Nowadays laryngeal cancer is often treated by transoral CO(2) laser microsurgery. Because of a variety of comorbidities, the incidence of perioperative complications in the group of elderly patients is of increasing interest. To date, no references in the literature have discussed complications after transoral CO(2) laser microsurgery in this age group. Patients and methods. Twenty-four patients over the age of 75 suffering from squamous cell carcinoma of the larynx and treated by transoral CO(2) laser microsurgery since 1998 were analysed for intraoperative and postoperative complications.

RESULTS

There was no evidence of surgery-related complications at all. Postoperatively, 6 of 24 patients complained about dysphagia. Due to intraoperative placement of nasogastric feeding tubes in these six cases further complications such as pneumonia resulting from aspiration could have been avoided.

摘要

结论

如果原发肿瘤的范围允许安全切除,老年喉癌患者应进行根治性治疗。经口二氧化碳激光显微手术的主要并发症发生率较低,即使对老年患者也可视为适用。年龄本身绝不应该是决定采取何种治疗方法的唯一因素。

目的

在工业化国家,75岁以上的年龄组将稳步增长,未来需要医疗专业人员给予特别关注。如今,喉癌常采用经口二氧化碳激光显微手术治疗。由于存在多种合并症,老年患者围手术期并发症的发生率越来越受到关注。迄今为止,文献中尚无关于该年龄组经口二氧化碳激光显微手术后并发症的报道。患者与方法。对1998年以来接受经口二氧化碳激光显微手术治疗的24例75岁以上喉鳞状细胞癌患者的术中及术后并发症进行分析。

结果

完全没有手术相关并发症的迹象。术后,24例患者中有6例抱怨吞咽困难。由于在这6例患者中术中放置了鼻胃饲管,本可避免诸如误吸导致的肺炎等进一步并发症。

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