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经口咽部乳头瘤的 KTP 激光与冷钢在门诊手术中的疗效比较。

Comparative Efficacy of the KTP Laser and Cold Steel in Office-Based Surgery for Oropharyngeal Papilloma.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.

出版信息

Ear Nose Throat J. 2024 Jun;103(6):NP345-NP350. doi: 10.1177/01455613211053413. Epub 2021 Nov 9.

Abstract

This study aims to compare the efficacy of the potassium-titanyl-phosphate (KTP) laser and cold steel surgery in treating oropharyngeal papilloma. Between 2017 and 2020, we enrolled 242 patients with oropharyngeal papilloma who were treated with either the KTP laser (n = 160) or cold steel surgery (n = 82). Patient charts were reviewed for demographic data (age and gender), pathology, anatomical location of lesions, operative duration, pain rating, residual disease, and recurrence. The oropharyngeal papillomas were successfully removed in all patients, except one with a significant pharyngeal reflex. There was no significant difference in the average time for lesion resection between KTP laser and cold steel group (18.11 ± 13.96 s vs 19.43 ± 16.91 s, > .05). However, all patients who underwent cold steel surgery experienced bleeding during the operation and required postoperative observation (about 20 min), making the total procedure time longer than that of the KTP laser procedure, which did not cause any intraoperative bleeding or require postoperative observation. After KTP laser treatment, the pain rating was .49 ± .98, whereas after cold steel surgery, it was .74 ± 1.12 ( = .058). Twenty-five samples were sent for human papillomavirus (HPV) testing, and one tested positive for both HPV 6 and 11 strains, while another tested positive for HPV 16. No residual disease or recurrence was observed at the treatment sites after a long period of follow-up (M = 15.35 ± 10.79 mo; range = 6-39 mo). The KTP laser provided a better hemostasis effect and a good surgical field of vision during the operation, allowing the surgeon to complete the procedure in less time. No significant difference in terms of pain rating, incision recovery, and postoperative recurrence between the KTP laser treatment and cold steel surgery.

摘要

本研究旨在比较钾钛磷(KTP)激光和冷钢手术治疗口咽乳头状瘤的疗效。2017 年至 2020 年,我们招募了 242 例口咽乳头状瘤患者,其中 160 例采用 KTP 激光治疗(KTP 激光组),82 例采用冷钢手术治疗(冷钢手术组)。回顾患者病历资料,包括人口统计学数据(年龄和性别)、病理学、病变解剖位置、手术时间、疼痛评分、残留病变和复发情况。除 1 例因咽反射明显而未能切除病变外,所有患者均成功切除口咽乳头状瘤。KTP 激光组和冷钢手术组的病变切除平均时间无显著差异(18.11±13.96 s 比 19.43±16.91 s,>0.05)。然而,所有接受冷钢手术的患者术中均有出血,需要术后观察(约 20 min),因此总手术时间长于 KTP 激光手术,后者术中无出血,无需术后观察。KTP 激光治疗后疼痛评分为 0.49±0.98,冷钢手术后疼痛评分为 0.74±1.12(=0.058)。25 例标本行人乳头瘤病毒(HPV)检测,1 例同时检测到 HPV6 和 11 型阳性,另 1 例检测到 HPV16 阳性。长期随访(M=15.35±10.79 mo;范围=6-39 mo)后,治疗部位未见残留病变或复发。KTP 激光在手术过程中提供了更好的止血效果和良好的手术视野,使外科医生能够更快地完成手术。KTP 激光治疗与冷钢手术在疼痛评分、切口恢复和术后复发方面无显著差异。

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