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[原发性二氧化碳激光声带切除术治疗声带癌]

[Primary CO2 laser chordectomy in vocal cord carcinoma].

作者信息

Czigner J, Sávay L

机构信息

Hals-Nasen-Ohren-Klinik, Med. Universität Szeged, Ungarn.

出版信息

Laryngorhinootologie. 1994 Aug;73(8):432-6. doi: 10.1055/s-2007-997167.

Abstract

A study was performed with laryngo-microscopic CO2 laser surgery on 55 patients suffering from histologically verified glottic cancer. They were treated by either "superficial laser chordectomy", or "partial cordectomy", "total chordectomy", or "extended chordectomy" in stages Tis = 7, T1a = 34, T1b = 11, and T2 = 3. All patients with Tis remained free of tumours, in stage T1a 88% (30/34) of the patients after laser chordectomy and 2 patients after partial- and total laryngectomy. In stage T1b the recurrence rate was higher (3/11 = 27%), but 2 patients after partial laryngectomy, and one patient after radiotherapy have become tumour-free, and thus all patients in this group are free from tumours. One of the 3 patients in stage T2 developed a local tumour recurrence, but after partial laryngectomy he is free from tumour and hence all 3 patients are still alive. Laser chordectomy proved a sufficient therapeutic procedure in 47 (85%) of 55 patients; eventually 95% of the patients became tumour-free. The authors emphasise that CO2 laser chordectomy is a modern and useful surgical method in the therapy of a vocal cord carcinoma, provided adequate follow-up and the possibility of "salvage" surgery are available.

摘要

对55例经组织学证实为声门癌的患者进行了喉显微二氧化碳激光手术研究。根据Tis期7例、T1a期34例、T1b期11例和T2期3例,分别采用“浅表激光声带切除术”“部分声带切除术”“全声带切除术”或“扩大声带切除术”进行治疗。所有Tis期患者均无肿瘤复发;T1a期患者中,激光声带切除术后88%(30/34)的患者无肿瘤复发,部分喉切除术和全喉切除术后各有2例患者无肿瘤复发。T1b期患者的复发率较高(3/11 = 27%),但部分喉切除术后有2例患者、放疗后有1例患者无肿瘤复发,因此该组所有患者均无肿瘤复发。T2期的3例患者中有1例出现局部肿瘤复发,但部分喉切除术后无肿瘤复发,因此所有3例患者均存活。55例患者中有47例(85%)经激光声带切除术证明是一种充分的治疗方法;最终95%的患者无肿瘤复发。作者强调,二氧化碳激光声带切除术是治疗声带癌的一种现代且有用的手术方法,前提是要有充分的随访以及“挽救性”手术的可能性。

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