Guerry T L, Silverman S, Dedo H H
Ann Otol Rhinol Laryngol. 1986 Nov-Dec;95(6 Pt 1):547-55. doi: 10.1177/000348948609500601.
A retrospective medical record review was done of 51 consecutive patients with 56 biopsy-proven squamous cell carcinomas of the oral cavity and oropharynx treated for cure by one of the authors (H.H.D.) using the carbon dioxide laser via microdirect pharyngoscopy. All 51 patients were followed for at least 3 years unless they died, and 27 were followed for 5 years. The tumors treated were superficial, accessible lesions without bone involvement or clinically apparent metastases. Eighteen patients had had irradiation or surgery at the same site, so were having salvage CO2 laser surgery. Indications and technique are discussed. Local recurrence and disease control rates were comparable to those of conventional local surgical excision at 3 and 5 years. Complication rate was low. Carbon dioxide laser resection with microscopic control is, we propose, an excellent modality for transoral excision of carefully selected lesions, and it offers increased precision, better visualization, minimal bleeding, and decreased postoperative morbidity compared to other surgical techniques.
对51例连续性患者进行了回顾性病历审查，这些患者经活检证实患有56例口腔和口咽鳞状细胞癌，由作者之一（H.H.D.）通过显微直接喉镜使用二氧化碳激光进行根治性治疗。所有51例患者均至少随访3年，除非死亡，其中27例随访5年。所治疗的肿瘤为表浅、易于触及的病变，无骨质受累或临床明显转移。18例患者曾在同一部位接受过放疗或手术，因此接受挽救性二氧化碳激光手术。讨论了适应证和技术。局部复发率和疾病控制率在3年和5年时与传统局部手术切除相当。并发症发生率低。我们认为，在显微镜控制下进行二氧化碳激光切除是经口切除精心选择病变的一种极佳方式，与其他手术技术相比，它具有更高的精确性、更好的视野、最少的出血以及更低的术后发病率。
