Eckel H E, Thumfart W F
Universitäts-HNO-Klinik Köln.
HNO. 1990 May;38(5):179-83.
From 1986 to 1988 ninety four patients with carcinoma of the larynx were treated by endoscopic laser surgery. Follow-up ranges from 3 to 39 months with a mean value of 23 months. Ninety patients were operated on with curative intent and 4 with palliative intent. In 7 cases of T3 tumors a complete removal of the tumor was not possible, so that a total laryngectomy could not be avoided. In all cases of T2 cancers of the glottic and subglottic level a definite resection was possible. Follow-up investigations showed 3 recurrences in the larynx so far. These were treated by laryngectomy. Recurrences in the cervical nodes were seen in two patients following resection of a supraglottic and a subglottic tumor. The authors believe that laser surgery may obviate the need for total laryngectomies in certain stages of laryngeal cancer, especially in T2 tumors. T3 tumors should not be treated by endolaryngeal laser surgery. At present, the number of recurrences and the rate of survival show no significant difference to those after conventional surgery. The phonatory function is not always predictable, and still needs to be investigated.
1986年至1988年期间,94例喉癌患者接受了内镜激光手术治疗。随访时间为3至39个月,平均为23个月。90例患者接受手术的目的是根治,4例是姑息性手术。在7例T3期肿瘤病例中,无法完全切除肿瘤,因此无法避免全喉切除术。在所有声门和声门下T2期癌症病例中,都有可能进行明确的切除。随访调查显示,到目前为止,喉部有3例复发,均接受了喉切除术。在1例声门上肿瘤和1例声门下肿瘤切除术后,2例患者出现颈部淋巴结复发。作者认为,激光手术在喉癌的某些阶段,尤其是T2期肿瘤,可能无需进行全喉切除术。T3期肿瘤不应采用喉内激光手术治疗。目前,复发率和生存率与传统手术后相比无显著差异。发声功能并不总是可预测的,仍需进一步研究。