挽救性经口激光显微手术治疗放射性复发性喉癌：适应证、局限性及疗效
Salvage Transoral Laser Microsurgery for Radiorecurrent Laryngeal Cancer: Indications, Limits, and Outcomes.
作者信息
Meulemans J, Delaere P, Nuyts S, Clement P M, Hermans R, Vander Poorten V
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium.
出版信息
Curr Otorhinolaryngol Rep. 2017;5(1):83-91. doi: 10.1007/s40136-017-0143-7. Epub 2017 Feb 7.
PURPOSE OF REVIEW
The aim of this report is to identify relevant literature reports on salvage transoral laser microsurgery (TLM); to consider its oncologic and functional outcomes, as well as reported complications; and to address indications and limitations of salvage TLM.
FINDINGS
The weighted average of local control after first salvage TLM was 57%. Repeated TLM procedures for second or third recurrences were required in up to 41% of cases, resulting in a weighted average of local control with TLM alone of 67%. The rate of definite laryngeal preservation was 73%. The ultimate local control rate, including cases that required total laryngectomy, was 90%. The overall complication rate after salvage TLM was 14%.
SUMMARY
Salvage TLM of radiorecurrent laryngeal cancer yields excellent oncologic outcomes. Serious complications are scarce, hospitalization times are short, and functional outcomes in terms of voice and swallowing are favorable when compared to open conservation laryngeal surgery. The key to success is an optimal patient selection.
综述目的
本报告旨在识别有关挽救性经口激光显微手术（TLM）的相关文献报道；考量其肿瘤学和功能学结果以及所报道的并发症；并探讨挽救性TLM的适应证和局限性。
研究结果
首次挽救性TLM后的局部控制加权平均值为57%。高达41%的病例需要针对第二次或第三次复发进行重复TLM手术，单独使用TLM的局部控制加权平均值为67%。确切的喉保留率为73%。包括需要全喉切除术的病例在内，最终局部控制率为90%。挽救性TLM后的总体并发症发生率为14%。
总结
放射性复发性喉癌的挽救性TLM产生了优异的肿瘤学结果。严重并发症罕见，住院时间短，与开放性保喉手术相比，在声音和吞咽方面的功能学结果良好。成功的关键是优化患者选择。
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