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经口激光显微手术治疗声门良性、癌前及恶性(Tis、T1、T2)病变:文献综述

CO Transoral Laser Microsurgery in Benign, Premalignant and Malignant (Tis, T1, T2) Lesion of the Glottis. A Literature Review.

作者信息

Chiesa-Estomba Carlos Miguel, González-García Jose Angel, Larruscain Ekhiñe, Calvo-Henríquez Christian, Mayo-Yáñez Miguel, Sistiaga-Suarez Jon A

机构信息

Otorhinolaryngology-Head & Neck surgery Department, Hospital Universitario Donostia, 20014 San Sebastian-Donostia, Spain.

Biodonostia Health Research Institute, 20014 San Sebastian-Donostia, Spain.

出版信息

Medicines (Basel). 2019 Jul 22;6(3):77. doi: 10.3390/medicines6030077.

Abstract

Carbon Dioxide transoral laser microsurgery represents a reliable option for the treatment of early glottic carcinoma (Tis-T2), with good functional and oncological outcomes, nowadays representing one of the main options in larynx preservation protocols. The development and improvement of laser devices means surgeons are able to use more precise instruments compared with classic cold dissection in laser-assisted phonosurgery. Secondary effects on voice, swallowing, or quality of life as well as complications have been well documented. Also, with the introduction of a new proposal for staging systems following the principle of the three-dimensional map of isoprognostic zones, the use of narrow-band imaging in clinical evaluation and intraoperative, and the implementation of diffusion-weighted magnetic resonance during preoperative evaluation, the development of new tools to improve surgical quality and preliminary reports regarding the use of carbon dioxide laser in transoral robotic surgery suggests an exciting future for this technique.

摘要

二氧化碳经口激光显微手术是治疗早期声门癌(Tis-T2)的一种可靠选择,具有良好的功能和肿瘤学效果,如今已成为喉保留方案的主要选择之一。激光设备的发展和改进意味着与传统的激光辅助嗓音外科冷剥离相比,外科医生能够使用更精确的器械。对嗓音、吞咽或生活质量的次要影响以及并发症都有充分的文献记载。此外,随着遵循等预后区三维地图原则的新分期系统建议的引入、窄带成像在临床评估和术中的应用,以及术前评估中扩散加权磁共振成像的实施,用于提高手术质量的新工具的开发以及关于二氧化碳激光在经口机器人手术中应用的初步报告表明该技术前景广阔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e36/6789531/d8315f19eb08/medicines-06-00077-g001.jpg

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