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灌注聚焦:重塑口咽鳞状细胞癌手术

Spotlight on Perfusion: Reshaping Oropharyngeal Squamous Cell Carcinoma Surgery.

作者信息

Dip Fernando, Artero Guillermo, Rancati Alberto, Ghiselli Javier I, Aleman Rene

机构信息

Department of General Surgery, University of Buenos Aires, Buenos Aires, ARG.

Heart, Vascular, and Thoracic Institute, Cleveland Clinic Florida, Weston, USA.

出版信息

Cureus. 2025 Jul 7;17(7):e87480. doi: 10.7759/cureus.87480. eCollection 2025 Jul.

Abstract

Oropharyngeal squamous cell carcinoma (OPSCC), commonly referred to as throat or tonsil cancer, is a type of head and neck malignancy arising from the base and posterior third of the tongue, tonsils, soft palate, and posterolateral pharyngeal walls. Standard treatment typically involves a single modality or a combination of surgery, radiotherapy, and/or chemotherapy. Despite favorable oncologic outcomes, chemoradiation is associated with considerable acute and long-term toxicities, including treatment-related mortality, debilitating dysphagia, fibrosis, severe xerostomia, and an increased risk of secondary malignancies. In this context, fluorescence-guided surgery (FGS) has emerged as a promising, minimally invasive intraoperative tool for OPSCC surgery. By leveraging indocyanine green (ICG), FGS offers enhanced visualization and real-time tissue differentiation, facilitating precise tumor resection and reducing the risk of surgical complications. This case presents an 83-year-old female patient who underwent radical OPSCC resection followed by complex reconstructive surgery utilizing a novel near-infrared FGS device.

摘要

口咽鳞状细胞癌(OPSCC),通常称为咽喉癌或扁桃体癌,是一种头颈部恶性肿瘤,起源于舌根、扁桃体、软腭和咽后壁的底部及后三分之一处。标准治疗通常涉及单一模式或手术、放疗和/或化疗的联合应用。尽管肿瘤学结局良好,但放化疗会带来相当多的急性和长期毒性,包括与治疗相关的死亡率、使人衰弱的吞咽困难、纤维化、严重口干以及继发性恶性肿瘤风险增加。在此背景下,荧光引导手术(FGS)已成为一种有前景的、用于OPSCC手术的微创术中工具。通过利用吲哚菁绿(ICG),FGS提供了增强的可视化和实时组织区分能力,有助于精确的肿瘤切除并降低手术并发症的风险。本病例介绍了一名83岁女性患者,她接受了根治性OPSCC切除术,随后使用一种新型近红外FGS设备进行了复杂的重建手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5854/12329617/8b1c689c3f54/cureus-0017-00000087480-i01.jpg

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