Zeitels S M, Davis R K
Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Boston 02130, USA.
Am J Otolaryngol. 1995 Jan-Feb;16(1):2-11. doi: 10.1016/0196-0709(95)90002-0.
Current concepts of endoscopic management of supraglottic cancer are an extension of precepts fostered by Jackson. The current approach has been facilitated by a half century of technological developments: the surgical microscope, the CO2 laser, improved laryngoscopes, and general endotracheal anesthesia. Selected small-volume cancers can be curatively resected, whereas excisional biopsy can be performed on larger neoplasms. With this cost effective minimally-invasive surgical approach, there is less disturbance of normal tissue, thereby minimizing morbidity rate and hospitalization. If the transoral excision is inadequate, radiotherapy can not be depended on to eradicate known residual disease. Endoscopic resection of supraglottic cancer should not alter the surgeon's standard management of the neck.
当前声门上癌的内镜治疗理念是杰克逊所倡导原则的延伸。半个世纪以来的技术发展推动了当前的治疗方法：手术显微镜、二氧化碳激光、改良喉镜以及全身气管内麻醉。部分小体积癌症可通过手术治愈切除，而对于较大肿瘤则可进行切除活检。采用这种具有成本效益的微创外科手术方法，对正常组织的干扰较小，从而将发病率和住院时间降至最低。如果经口切除不充分，不能依赖放射治疗来根除已知的残留病灶。声门上癌的内镜切除不应改变外科医生对颈部的标准治疗方案。
