DU Yuxiao, Yang Xiangli, Han Weiwei, Liu Jixiang
Department of Otorhinolaryngology Head and Neck Surgery,Tianjin Union Medical Center,Tianjin,300122,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Jul;38(7):646-650. doi: 10.13201/j.issn.2096-7993.2024.07.017.
To explore efficacy of narrow band imaging(NBI) technique in CO2laser therapy in Early-Stage Glottic cancer. The clinical data of patients with Early-Stage Glottic cancer who underwent CO2laser vocal cord resection from June 2011 to August 2022 were retrospectively analyzed. Among these, 27 patients who underwent surgery assisted by NBI were assigned to the observation group, while 25 patients who underwent conventional CO2 laser microsurgery with a suspension laryngoscope were assigned to the control group. The differences between the two groups were analyzed in terms of intraoperative frozen pathology results, postoperative recurrence rates, 5-year cumulative disease-free survival rates, complications, and voice recovery. All 52 patients were operated successfully. Temporary tracheostomy and serious complications did not occur during the operation. The postoperative patient's pronunciation was satisfactory. One patient experienced vocal cord adhesion, but there were no severe complications such as breathing difficulties or bleeding, with an overall complication rate of 1.92%. Postoperative follow-up was 1-5 years. The 5 years recurrence free survival in the general group was 77.90%, and the 5 years recurrence free survival in the NBI group was 100%, the difference was statistically significant(<0.05). NBI endoscopy is safer and more accurate than the general group in determining the safe margin of tumor mucosal resection(<0.05). Among the patients who accepted the voice analysis, the difference was no statistically significant(>0.05). Compared with conventional CO2laser surgery under microscope, NBI guided laser resection of Early-Stage Glottic cancer is more accurate. NBI guided laser resection could improve 5 years recurrence free survival rate. In a word, narrow-band imaging endoscopy can has very high value in clinical application.
探讨窄带成像(NBI)技术在早期声门癌二氧化碳激光治疗中的疗效。回顾性分析2011年6月至2022年8月期间接受二氧化碳激光声带切除术的早期声门癌患者的临床资料。其中,27例行NBI辅助手术的患者被分配到观察组,25例行传统二氧化碳激光显微手术联合支撑喉镜的患者被分配到对照组。分析两组在术中冰冻病理结果、术后复发率、5年累积无病生存率、并发症及嗓音恢复方面的差异。52例患者均手术成功。术中未发生临时气管切开及严重并发症。术后患者发音满意。1例患者发生声带粘连,但无呼吸困难或出血等严重并发症,总体并发症发生率为1.92%。术后随访1 - 5年。总体组5年无复发生存率为77.90%,NBI组5年无复发生存率为100%,差异有统计学意义(<0.05)。NBI内镜在确定肿瘤黏膜切除安全切缘方面比总体组更安全、准确(<0.05)。在接受嗓音分析的患者中,差异无统计学意义(>0.05)。与传统显微镜下二氧化碳激光手术相比,NBI引导下早期声门癌激光切除术更准确。NBI引导下激光切除术可提高5年无复发生存率。总之,窄带成像内镜在临床应用中具有很高的价值。