摘要
目的:探讨经口内镜下CO2激光显微外科手术治疗早期声门型喉癌的疗效。方法:回顾性分析1999年10月～2004年8月接受CO2激光显微外科手术治疗声门型喉癌患者91例(Tis9例,pT1a45例,pT1b25例,pT212例)。声带切除方式按2000年欧洲喉科学会制定分类方案划分。结果:依照Kaplan-Meier方法计算5年局部无复发率:Tis100.00%,T1a93.33%,T1b84.00%,T275.00%,组间差异无统计学意义(P>0.05)。病变侵犯前联合5年局部无复发率78.57%(6/28),未侵犯前连合5年局部无复发率93.65%(4/63),组间差异有统计学意义(χ2=4.348,P<0.05)。5年整体生存率92.72%,无瘤生存率84.62%。术后6个月GRBAS声音嘶哑评估:Ⅰ、Ⅱ型术后评分正常或轻度异常水平;Ⅲ、Ⅳ、Ⅴ型手术术后嗓音大部分有轻度至中度嘶哑音。结论:CO2激光显微外科对治疗早期声门型喉癌是有效的治疗方法。
Objective：To explore the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carcinoma. Method：Retrospectively study 91 patients with glottie carcinoma （9 Tis, 45 pT1a, 25 pT1b, 12 pT2 ） treated in our department from October 1999 to August 2004. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society in 2000. Result： According to the Kaplan-Meier method, the probability of remaining free of local recurrence 5 years after primary surgery alone c was 100.00% for the Tis, 93.33% for the T1a, 84.00% for T1b and 75.00% for the T2 respectively, without Tstatis tical significance of various groups by the Log- Rank tests（ P 〉0.05）. The probability of remaining free of local recurrence 5 years after primary surgery alone was 78.57% （6/28） of tumors offended the anterior commissure, versus 93. 65% （4/63） with no involvement of anterior commissure, have staTtis tical significance（ P 〈 0.01）. The 5 year overall survival and the disease free survival were 92.72% and 84.62% respectively. Perceptive evaluation was performed with the ＂GRBAS＂ evaluation system 6 month after laser operation. All patients in the group of type Ⅰ and type Ⅱhad an normal voice or mild dysphonia . The patients treated with type Ⅲ, type and type V had a mild or moderate vocal disease. Conclusion：According to the present series, endoscopic CO2 laser surgery is an effective treatment for early glottic cancer.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2007年第21期985-987,共3页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
喉肿瘤
激光手术
喉切除术
Laryngeal neoplasms
Laser surgery
laryngectomy
