Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
Head Neck. 2012 Jul;34(7):1028-35. doi: 10.1002/hed.21766. Epub 2011 Apr 15.
Current practice standards for the treatment of early to moderately advanced laryngeal and hypopharyngeal cancer demand both achievement of cure and preservation of laryngeal structure and function to the greatest extent possible. The oncologic and functional results of transoral laser microsurgery (TLM) for early glottic cancer appear to be comparable to those of radiotherapy, with a higher rate of laryngeal preservation and a lower cost. TLM for early and moderately advanced supraglottic and hypopharyngeal cancers offers similar results with regard to survival and local control to those obtained with open surgical approaches. In addition, functional results of TLM are superior to those of open approaches because tracheotomies are usually avoided, rehabilitation of swallowing is faster, and hospital stay is shorter. TLM, when applicable, has become the preferred modality for surgical treatment of most early to moderately advanced cancers of the larynx and selected tumors of the hypopharynx.
目前，治疗早期到中度进展期喉和声门上喉癌的标准做法是，在最大程度上实现治愈并保留喉结构和功能。经口激光微创手术（TLM）治疗早期声门型癌症的肿瘤学和功能结果似乎与放疗相当，具有更高的喉保留率和更低的成本。对于早期和中度进展期声门上喉和下咽癌，TLM 的生存率和局部控制率与开放式手术相当。此外，TLM 的功能结果优于开放式手术，因为通常可以避免气管切开术，吞咽功能的康复更快，住院时间更短。TLM 在适当时已成为大多数早期到中度进展期喉癌和选定的下咽肿瘤的首选手术治疗方式。
