经鼻内镜切除术治疗选择的恶性肿瘤：十年经验。

Nasopharyngeal endoscopic resection in the management of selected malignancies: ten-year experience.

机构信息

Department of Otorhinolaryngology, University of Insubria, Varese, Italy.

出版信息

Rhinology. 2010 Mar;48(1):84-9. doi: 10.4193/Rhin09.079.

DOI:10.4193/Rhin09.079

PMID:20502741

Abstract

OBJECTIVE

To evaluate the feasibility of endoscopic surgery in the management of selected nasopharyngeal cancers. Three different types of nasopharyngeal endoscopic resections (NER) are described.

METHOD OF STUDY

From January 1997 to October 2008, 17 consecutive patients (mean age: 50 years) with previously untreated (5) or recurrent nasopharyngeal tumours (12) were treated with curative intent by pure endoscopic resection. The extent of surgical resection was classified as follows: type I NER: resection limited to the postero-superior nasopharyngeal wall; type 2 NER: resection superiorly extended to the sphenoid sinus; type 3 NER: resection with lateral extension including the cartilaginous portion of the Eustachian tube and parapharyngeal space.

RESULTS

Type 1 NER was performed in 4 cases, type 2 in 6, and type 3 in 7. No intra- or post-operative complications were observed. Mean hospitalization time was 4 days (range: 1-7). Follow-up ranged from 10 to 138 months (mean: 41.2±38). At the time of writing, 12 (71/%) patients were free of disease, 3 (17%) alive with disease, and 2 (12%) dead of disease.

CONCLUSIONS

NER is a feasible surgical technique that can be tailored in relation to tumour extension. Larger series and longer follow-up are needed to further validate the long-term results.

摘要

目的

评估内镜手术治疗选择的鼻咽癌的可行性。描述了三种不同类型的鼻咽内镜切除术（NER）。

研究方法

从 1997 年 1 月至 2008 年 10 月，17 例未经治疗的（5 例）或复发性鼻咽肿瘤患者（12 例）连续接受了根治性内镜切除术。手术切除的范围如下：1 型 NER：仅限于后上鼻咽壁的切除；2 型 NER：向上延伸至蝶窦；3 型 NER：包括咽鼓管软骨部分和咽旁间隙的侧方扩展的切除。

结果

4 例患者行 1 型 NER，6 例患者行 2 型 NER，7 例患者行 3 型 NER。无术中或术后并发症。平均住院时间为 4 天（范围：1-7 天）。随访时间为 10-138 个月（平均：41.2±38 个月）。截至撰写本文时，12 例（71%）患者无疾病，3 例（17%）患者带瘤生存，2 例（12%）患者死于疾病。