Otolaryngology-Head and Neck Surgery Department, University Hospital of Louvain at Mont-Godinne, Dr Therasse Avenue, No. 1, 5530 Yvoir, Belgium.
Eur Arch Otorhinolaryngol. 2010 Mar;267(3):397-400. doi: 10.1007/s00405-009-1101-x. Epub 2009 Sep 27.
Endoscopic resection of laryngeal tumors is replacing external approaches. One drawback of endoscopic resection is the difficulty of interpretation of histological specimens because of thermal effect of laser on tissues. Our goal is to assess the reliability of frozen section in this setting by comparing its results with those of routine histology. We, retrospectively, reviewed the charts of all consecutive patients, who underwent cordectomies in our institution between January 2000 and 2008, using the CO(2) laser Acublade system (Lumenis, Santa Clara, CA). Age, sex, staging of the tumor, previous treatments, type of cordectomy, frozen section and routine histology results were analyzed. Ninety-seven patients fulfilled the inclusion criteria; 22.7% had severe dysplasia, 54.6% had T1 epidermoid carcinoma, 17.5% had T2 carcinoma and finally 5.2% had T3 carcinoma. We performed type I cordectomy in 36.1% of patients, type II cordectomy in 18.6%, type III cordectomy in 10.3%, type IV cordectomy in 5.2%, type V cordectomy in 28.9% and type VI cordectomy in 1% of patients. Most of the patients did not have any previous treatment. The mean number of margins per surgery was 2. Routine histological examination confirmed frozen section in 94.8% of the interventions. Frozen section is reliable in laser-assisted cordectomies, when performed by an experienced team; it has a high negative-predictive value. It can limit the need, cost and emotional stress of second look surgeries.
喉肿瘤的内镜切除术正在取代外部方法。内镜切除的一个缺点是由于激光对组织的热效应，组织学标本的解释困难。我们的目标是通过将其结果与常规组织学结果进行比较，来评估冷冻切片在此环境下的可靠性。我们回顾性地审查了 2000 年 1 月至 2008 年期间在我们机构接受声带切除术的所有连续患者的图表，使用 CO （2）激光 Acublade 系统（Lumenis，加利福尼亚州圣克拉拉）。分析了年龄、性别、肿瘤分期、先前的治疗、声带切除术的类型、冷冻切片和常规组织学结果。97 例患者符合纳入标准；22.7%有严重发育不良，54.6%有 T1 表皮样癌，17.5%有 T2 癌，最后 5.2%有 T3 癌。我们对 36.1%的患者进行了 I 型声带切除术，18.6%的患者进行了 II 型声带切除术，10.3%的患者进行了 III 型声带切除术，5.2%的患者进行了 IV 型声带切除术，28.9%的患者进行了 V 型声带切除术，1%的患者进行了 VI 型声带切除术。大多数患者没有任何先前的治疗。每例手术的平均边缘数为 2 个。常规组织学检查在 94.8%的干预中证实了冷冻切片。当由经验丰富的团队进行时，冷冻切片在激光辅助声带切除术是可靠的；它具有很高的阴性预测值。它可以限制二次手术的需要、成本和情绪压力。
