McGuirt W F, Koufman J A
Arch Otolaryngol Head Neck Surg. 1987 May;113(5):501-5. doi: 10.1001/archotol.1987.01860050047012.
Thirty-three patients with newly diagnosed laryngeal carcinoma underwent endoscopic treatment with the carbon dioxide laser under microscopic control and venturi jet ventilation. Ten of these patients underwent emergency tumor debulking to relieve airway obstruction and to avoid emergency tracheotomy for airway control, and 23 had definitive treatment of superficial or frankly invasive carcinoma. Among the first group, all had an adequate airway after tumor debulking and could be treated with elective laryngectomy with or without radical neck dissection once their metabolic conditions had improved and they had been appropriately evaluated. Among the second group, two died of lung carcinoma but were free of laryngeal disease and two were lost to follow-up at one year. With a minimal three-year follow-up, six of the remaining 19 patients underwent additional laser procedures. None have required external laryngeal surgery or radiation therapy. Endoscopic laser therapy appears preferable to a more radical approach for carcinoma in situ, microinvasive carcinoma, or superficially invasive carcinoma of the larynx.
33例新诊断的喉癌患者在显微镜控制和文丘里喷射通气下接受了二氧化碳激光内镜治疗。其中10例患者接受了紧急肿瘤减容术，以缓解气道阻塞并避免为控制气道而行紧急气管切开术，23例患者接受了浅表性或明显浸润性癌的确定性治疗。在第一组中，所有患者在肿瘤减容术后气道均通畅，一旦其代谢状况改善并经过适当评估，可接受选择性喉切除术，可同时或不进行根治性颈清扫术。在第二组中，2例死于肺癌，但喉部无病变，2例在1年后失访。经过至少3年的随访，其余19例患者中有6例接受了额外的激光治疗。无人需要进行外部喉部手术或放射治疗。对于喉原位癌、微浸润癌或浅表浸润癌，内镜激光治疗似乎比更激进的方法更可取。
