经口入路低温等离子切除早期声门型喉癌的中长期随访结果  

Mid-and Long-term Follow-up Results of Transoral Low Temperature Plasma Ablation for Early Glottic Laryngeal Cancer

作　　者：曾进[1] 谢华顺[1] 李丽娟[1] 杜晨[1] 闫燕[1] 刘仲奇[1] 王丽[1] Zeng Jin;Xie Huashun;Li Lijuan(Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100191, China)

机构地区：[1]北京大学第三医院耳鼻咽喉科,北京100191

出　　处：《中国微创外科杂志》2021年第3期210-214,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经口入路低温等离子切除早期声门型喉癌的效果。方法2011年9月~2016年1月对105例早期声门型喉癌(T1期87例,T2期18例)全麻下行经口入路低温等离子喉肿瘤切除术,术后定期随访,观察肿瘤复发、转移及生存情况。术后第1年喉镜每3个月复查1次,第2~5年每6个月复查1次,5年以后每年复查1次;颈部超声为6个月复查1次;胸部CT为每年复查1次。结果105例均在内镜下行低温等离子肿瘤切除术,未发生气道爆燃或气道黏膜灼伤等医疗不良事件。2例术后发热及肺部感染,抗生素治疗5~7 d后复查胸片,肺部感染控制后出院。6例术后出现声带粘连,主要表现为声音嘶哑,无明显喉梗阻症状,不影响患者生活质量。2例术后出现颈前皮下气肿,3 cm×3 cm以内,术后3 d皮下气肿逐步消退。术后病理均为喉部鳞状细胞癌。98例中位随访时间61.8月(14~100个月),11例发生喉腔局部肿瘤复发,1、2、3年累积复发率分别为0%、9.2%、11.2%;5例发生颈部淋巴结转移,1、2、3年累积转移率分别为0%、3.1%、5.1%;17例死亡,其中10例死于喉癌及肿瘤复发,5例死于肺癌(考虑为多重癌),2例死于心脑血管疾病,1、3、5年累积生存率分别为100.0%、91.4%、83.8%。结论经口入路低温等离子切除早期声门型喉癌总体疗效满意。Objective To study the clinical effect of transoral hypothermic plasma resection for early glottic laryngeal cancer.Methods A total of 105 patients with early glottic laryngeal cancer from September 2011 to January 2016 in our department were reviewed.Among them,87 patients were in T1 stage and 18 patients were in T2 stage.They underwent low-temperature plasma laryngectomy via oral approach under general anesthesia.The patients were followed up regularly to observe the recurrence,metastasis and survival rate after operation.In the first year after operation,laryngoscope was re-examined every 3 months,in the second to fifth year,every 6 months,and every year after 5 years.The neck ultrasonography was re-examined every 6 months,and chest CT every year.Results All the 105 patients underwent endoscopic low-temperature plasma tumor resection,and no adverse medical events such as airway deflagration or airway mucosa burn occurred.There were 2 cases of postoperative fever and pulmonary infection,who were given antibiotic treatment for 5-7 days after the review of chest X-ray,and were discharged after the control of pulmonary infection.There were 6 cases of postoperative vocal cord adhesions,mainly manifested as hoarseness and no obvious symptoms of laryngeal obstruction,which did not affect the quality of life of patients.Subcutaneous emphysema was found in 2 cases,within 3 cm×3 cm.The subcutaneous emphysema gradually subsided 3 days after operation.Postoperative pathology was squamous cell carcinoma of the larynx.The median follow-up time of 98 cases was 61.8 months(range,36-100 months).Local tumor recurrence occurred in 11 cases and cervical lymph node metastasis occurred in 5 cases.The cumulative recurrence rates in the 1-,2-and 3-year were 0%,9.2%and 11.2%respectively,and the cumulative metastasis rates in the 1-,2-and 3-year were 0%,3.1%and 5.1%respectively.A total of 17 cases died,including 10 cases of laryngeal cancer and tumor recurrence,5 cases of lung cancer(considered as multiple cancer),and 2 cases of cardi

关 键 词：声门型喉癌 低温等离子 复发 

分 类 号：R73[医药卫生—肿瘤]