等离子射频辅助经口内镜微创切除浅表舌根肿瘤  

Transoral coblation-assisted endoscopic minimally invasive surgery for superficial tongue base tumours

作　　者：李五一[1] 霍红[1] 杨大海[1] 刘建汉[1] 王剑[1] 金晓峰[1] 牛燕燕[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,100730

出　　处：《中华耳鼻咽喉头颈外科杂志》2017年第5期332-336,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的 舌根肿瘤位置隐蔽，难以经口整块完整切除。本文拟探索简便、经济的舌根肿瘤经口微创手术方法。方法 2006年3月至2016年8月，采用等离子射频辅助经口内镜微创手术切除浅表舌根肿瘤15例。其中，恶性肿瘤9例（鳞状细胞癌3例，黏液表皮样癌2例，滤泡细胞癌1例，肌上皮癌1例，黏膜相关淋巴瘤1例，套细胞性非霍奇金淋巴瘤1例），良性肿瘤6例（血管瘤1例，舌根异位甲状腺伴结节囊性变1例，Cowden综合征伴舌根团簇状乳头状瘤增生、腺瘤、神经纤维瘤和淋巴增生不除外淋巴瘤各1例）。4例恶性肿瘤同期行颈淋巴清扫术，3例鳞状细胞癌术后辅助放疗，非霍奇金淋巴瘤患者行术后化疗。结果 除舌根异位甲状腺采用次全切除外，病变经口完整切除率92.86%（13/14），1例鳞状细胞癌因舌根深部出血经口止血困难，改为颈部开放手术。恶性肿瘤患者术后随访8-50个月，中位数20个月，套细胞性非霍奇金淋巴瘤患者2年后死于头颈其他部位复发。其余患者随访期间无复发。Cowden综合征患者术后神经内分泌癌合并肺转移后失访。术前预防性气管切开2例。患者术后第2-3天可以经口流食或稀半流食。结论 等离子射频经口辅助内镜微创手术能较好地用于切除舌根部浅表肿瘤。Objective To introduce the method of transoral coblation-assisted endoscopic minimally invasive surgery for superficial tongue base tumour. Methods A total of 15 patients treated with transoral coblation-assisted endoscopic minimally invasive surgery from Mar. 2006 to Aug. 2016 were retrospectively reviewed. There were 9 patients with malignant tumors, 6 patients with benign neoplasms. Adjuvant postoperative radiation therapy was applied in three cases of squamous cell carcinoma, neck was performed in four cases of cancer. One case of non-Hodgkin lymphoma received postoperative chemotherapy. Results One case with ectopic thyroid gland was treated by subtotal resection and one case with squamous cell carcinoma changed into open surgery because of major lingual artery bleeding. The En bloc resection under edoscope was achieved in 92. 86% （13/14） of patients. Fifteen cases of neoplasms were followed-up for 8 - 50 months （median 20 months ）, one patient with Cowden syndrome was lost to follow-up because of appendical carcinoid combined pulmonary metastasis, one patient with non-Hodgkin lymphoma died of recurrence in other head neck areas 2 years after chemotherapy. Conclusion Transoral eoblation-assisted endoscopic surgery can successfully treat for the patients with superficial tongue base tumours.

关 键 词：舌肿瘤 低温等离子 外科手术 微创性 

分 类 号：R739.86[医药卫生—肿瘤]