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经口低温等离子辅助显微外科治疗头颈肿瘤的初步效果

李五一,  刘建汉,  杨大海,  王剑,  霍红,  徐春晓,  陈兴明,  高志强

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文章导航 > 协和医学杂志  > 2012 >  3(2): 143-147
李五一, 刘建汉, 杨大海, 王剑, 霍红, 徐春晓, 陈兴明, 高志强. 经口低温等离子辅助显微外科治疗头颈肿瘤的初步效果[J]. 协和医学杂志, 2012, 3(2): 143-147. doi: 10.3969/j.issn.1674-9081.2012.02.004
引用本文: 李五一, 刘建汉, 杨大海, 王剑, 霍红, 徐春晓, 陈兴明, 高志强. 经口低温等离子辅助显微外科治疗头颈肿瘤的初步效果[J]. 协和医学杂志, 2012, 3(2): 143-147. doi: 10.3969/j.issn.1674-9081.2012.02.004
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Wu-yi LI, Jian-han LIU, Da-hai YANG, Jian WANG, Hong HUO, Chun-xiao XU, Xing-ming CHEN, Zhi-qiang GAO. Initial Efficacy of Transoral Coblation Microsurgery for Head and Neck Tumors[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(2): 143-147. doi: 10.3969/j.issn.1674-9081.2012.02.004
Citation: Wu-yi LI, Jian-han LIU, Da-hai YANG, Jian WANG, Hong HUO, Chun-xiao XU, Xing-ming CHEN, Zhi-qiang GAO. Initial Efficacy of Transoral Coblation Microsurgery for Head and Neck Tumors[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(2): 143-147. doi: 10.3969/j.issn.1674-9081.2012.02.004
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经口低温等离子辅助显微外科治疗头颈肿瘤的初步效果

doi: 10.3969/j.issn.1674-9081.2012.02.004

  • 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, 北京 100730

详细信息
    通讯作者:

    李五一 电话:010-69156311, E-mail:liwuyi@sina.com

  • 中图分类号: R739.6;R762

Initial Efficacy of Transoral Coblation Microsurgery for Head and Neck Tumors

  • Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

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    摘要
  • 摘要:   目的  探讨经口低温等离子辅助显微外科(transoral coblation microsurgery, TCM)治疗头颈肿瘤的初步效果。  方法  回顾性分析2008年5月至2011年10月间北京协和医院93例TCM治疗头颈肿瘤的手术资料。93例患者中, T1~T2期喉癌43例, 喉良性肿瘤14例, 口咽和喉咽恶性肿瘤10例, 咽良性肿瘤4例, 会厌谷囊肿13例, 咽旁间隙良性肿瘤9例。11例为开放手术或CO2激光手术后局部复发病例。3例咽癌同期行颈清扫术, 18例T2期喉癌和咽癌术后行辅助放疗。  结果  93例均达到内窥镜全切除标准。53例恶性肿瘤中, 51例一期切除, 2例因术后病理结果的变化行二次内镜等离子局部扩大切除; 40例良性肿瘤均一期切除。术后并发症包括迟发型出血3例, 轻度颈部皮下气肿2例, 咽部切口裂开4例, 前联合喉蹼和肉芽10例。初步随诊结果示:喉癌中位随访时间14.5个月(2~40个月), 局部复发2例。咽恶性肿瘤中位随访时间19个月(6~40个月), 1例失访, 其余无瘤生存; 喉、咽和咽旁间隙良性肿瘤中位随访时间17个月(2~37个月), 3例局部复发, 均为喉乳头状瘤。  结论  TCM可作为头颈肿瘤经口微创手术方法之一, 用于良性和T1~T2的早期恶性头颈肿瘤治疗。
    Abstract:   Objective  To investigate the initial efficacy of transoral coblation microsurgery (TCM) for head and neck tumors.  Methods  A total of 93 patients treated with TCM at Peking Union Medical College Hospital from May 2008 to October 2011 were retrospectively reviewed. Among them, 43 patients were with stage T1-T2 laryngeal cancers, 14 with laryngeal benign tumors, 10 with oro-hypopharyngeal cancers, 4 with benign tumors in the oro-hypopharynx, 13 with vallecular cysts, and 9 with benign tumors in the parapharyngeal space. Eleven patients had recurrent primary tumors following endoscopic or open-neck resections. Three patients had neck dissections, and 18 patients with stage T2 laryngeal cancers or oro-hypopharyngeal cancers received adjuvant radiotherapy.  Results  Total resection was achieved endoscopically in all the patients. Among 53 cases with malignant neoplasms, 51 cases underwent one-stage resection, and 2 cases underwent subsequent extended local resection according to the pathological results from the one-stage resection. As for the 40 cases with benign tumors, one-stage resection was achieved in all cases. The complications included postoperative hemorrhage in 3 cases, subcutaneous emphysema in 2 cases, dehiscence of the pharyngeal wounds in 4 cases, and laryngeal web or granulation in 10 cases. Patients with laryngeal cancers were followed up 2-40 months (median, 14.5 months), and 2 patients suffered local recurrence. Patients with pharyngeal malignant neoplasms were followed up 6-40 months (median, 19 months), 1 patient was lost and the others were disease-free. Patients with benign tumor in larynx, pharynx, and the parapharyngeal space were followed up 2-37 months (median, 17 months), and 3 patients with laryngeal papilloma suffered local recurrence.  Conclusion  TCM is a safe and effective treatment alternative for selected early malignant neoplasms at stage T1-T2 or benign tumors of head and neck.
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    • 参考文献(13)
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出版历程
  • 收稿日期:  2012-01-05
  • 刊出日期:  2012-04-30

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