摘要
目的探讨T3期喉癌采用支撑喉镜下CO2激光切除术和部分喉切除术两种手术治疗方式的临床治疗效果。方法将2003年8月-2010年7月收治的31例患者按所接受手术方式分为A、B两组(非随机分组),A组16例中男15例,女1例,年龄38～72岁,中位年龄51岁;B组15例,均为男性,年龄46～68岁,中位年龄58岁。病变均累及前联合,A组10例和B组11例累及对侧声带约1/3。A组选择支撑喉镜下CO2激光切除术,B组选择气管切开+部分喉切除术。两组患者首次术后均未接受放射(放疗)或化学治疗(化疗)。术后第1、3、6、12、24个月门诊纤维喉镜复查。随访时间14～78个月。结果 A组5例复发或颈部淋巴结转移,复发率31.3%;5例患者均行再次手术、颈清扫及放、化疗。B组4例复发,复发率26.7%;4例均行全喉切除双侧选择性颈清扫术,其中3例术后辅以放、化疗。两组复发率比较差异无统计学意义(P>0.05)。结论采用支撑喉镜下CO2激光切除治疗T3期喉癌,有望得到类似部分喉切除的临床治疗效果。
Objective To investigate the clinical efficacy of CO2 laser surgery and open partial laryngectomy in treating T3 glottic laryngeal carcinoma.Methods Thirty-one patients with T3 laryngeal carcinoma treated from August 2003 to July 2010 were non-randomly divided into two groups： group A and group B,with 16 and 15 patients respectively.Group A had 15 males and 1 female,aged between 38 and 72 with a median age of 51;group B was composed of all males,aged between 46 and 68 with a median age of 58.Anterior commissure was involved in all cases.About 1/3 of the other vocal cord was involved in 10 and 11 cases respectively in group A and group B.Patients in group A underwent CO2 laser surgery,while those in group B accepted partial laryngectomy.No adjuvant radiotherapy and chemotherapy was applied after the first-time operation in both groups.Postoperative fibrolaryngoscopic examinations were done to assess early recurrence signs 1,3,6,12 and 24 months after surgery.The follow-up duration lasted for 14 to 78 months.Results Five（31.3%） out of 16 patients in group A recurred in the laryngeal cavity or had cervical lymphatic metastases.They were treated by partial or total laryngectomy and selective neck dissection depending on early or late discovery of recurrence,followed by chemotherapy and radiotherapy.Four（26.7%） out of 15 patients failed in group B,and they were treated with total laryngectomy and bilateral selective neck dissection after which three of them were treated by radiotherapy and chemotherapy.There was no significant difference of recurrence rate between the two groups（P0.05）.Conclusions CO2 laser surgery employed for T3 laryngeal carcinoma is promising to get similar clinical results in comparison with partial laryngectomy if patients are properly selected.
出处
《华西医学》
CAS
2013年第1期53-55,共3页
West China Medical Journal
关键词
喉癌
肿瘤分期
激光手术
部分喉切除术
Laryngeal carcinoma
Tumor stage
Laser surgery
Partial laryngectomy
