Kimoto Akira, Suzuki Hiroaki, Yamashita Junya, Takeuchi Junichiro, Matsumoto Kousuke, Enomoto Yui, Komori Takahide
1 Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine , Kobe, Japan .
2 Department of Oral and Maxillofacial Surgery, Kita-harima Medical Center , Ono, Japan .
Photomed Laser Surg. 2017 Sep;35(9):479-483. doi: 10.1089/pho.2016.4160. Epub 2017 Mar 30.
The purpose of this study was to retrospectively evaluate the postoperative results of partial glossectomy for early tongue cancer using a carbon dioxide laser (CO laser).
CO lasers are frequently used for the excision or treatment of soft tissue in a range of diseases, including oral cancer, leukoplakia, mucocele, anomalies of the labial and lingual frenum, and peri-implantitis.
We retrospectively reviewed 31 primary cases of early superficial tongue cancer that were treated using CO lasers. In this study, early superficial cancer of the tongue is defined as a T1 or T2 tumor (TNM classification, NOMO; type, superficial spread, or exophytic; depth, <5 mm). The lesions were stained with 10% Lugol's solution and excised with a 5- or 10-mm safety margin from the nonstained area or induration using a CO laser. The raw surface was covered with a polyglycolic acid sheet using fibrin glue spray (n = 23), sutures (n = 6), or both (n = 2). Five of the patients showed a bleeding tendency: 1 was taking warfarin 100 mg per day, 1 was taking 350 mg per day, 2 were taking aspirin 100 mg per day, and 1 was taking aspirin 200 mg per day.
There were no cases of postoperative bleeding. Regarding postoperative pain, all patients could stop taking analgesic drugs by 1 month after undergoing the operation. In regards to postoperative difficulty to swallow, all could start swallowing rice gruel 2 days after the operation. The surgical margin was unclear in two cases due to the thermal denaturation of the excisional margin. The 2-year local control rate was 100% and subsequent cervical lymph node metastasis rate was 6.5%.
In terms of recurrence, metastasis, postoperative bleeding, postoperative pain, and swallowing, partial glossectomy for early tongue cancer using a CO laser might therefore help improve the postoperative course.
本研究的目的是回顾性评估使用二氧化碳激光（CO₂激光）治疗早期舌癌的部分舌切除术的术后结果。
CO₂激光常用于切除或治疗一系列疾病中的软组织，包括口腔癌、白斑、黏液囊肿、唇系带和舌系带异常以及种植体周围炎。
我们回顾性分析了31例使用CO₂激光治疗的早期浅表性舌癌原发性病例。在本研究中，早期浅表性舌癌定义为T1或T2肿瘤（TNM分类，N0M0；类型，浅表扩散或外生性；深度，<5 mm）。病变用10%卢戈氏溶液染色，然后使用CO₂激光从未染色区域或硬结处切除，切除边缘有5或10 mm的安全切缘。创面用纤维蛋白胶喷雾覆盖聚乙醇酸片（n = 23）、缝合（n = 6）或两者并用（n = 2）。5例患者有出血倾向：1例每天服用华法林100 mg，1例每天服用350 mg，2例每天服用阿司匹林100 mg，1例每天服用阿司匹林200 mg。
无术后出血病例。关于术后疼痛，所有患者在术后1个月均可停止服用镇痛药。关于术后吞咽困难，所有患者术后2天均可开始吞咽米粥。由于切除边缘的热变性，2例手术切缘不清晰。2年局部控制率为100%，随后的颈部淋巴结转移率为6.5%。
因此，就复发、转移、术后出血、术后疼痛和吞咽而言，使用CO₂激光治疗早期舌癌的部分舌切除术可能有助于改善术后病程。
