A Preliminary Study of CO2 Laser Surgery and Open Partial Laryngectomy in Treating T3 Glottic Laryngeal Carcinoma_West China Medical Journal

Authors：

LI Wen ¹ , SHI Liying ² , YANG Liu ¹ , L Hong ¹ , ZHOU Jian. ¹

1. Department of Otolaryngology, Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China; 2. Department of Otolaryngology, the 3rd Affiliated Hospital, Xinxiang Medical College, Xinxiang, Henan 453003, P. R. China;

Corresponding author：

Keywords：

喉癌; 肿瘤分期; 激光手术; 部分喉切除术

DOI：

10.7507/1002-0179.20130015

Video：

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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。

Citation： LI Wen,SHI Liying,YANG Liu,L Hong,ZHOU Jian.. A Preliminary Study of CO2 Laser Surgery and Open Partial Laryngectomy in Treating T3 Glottic Laryngeal Carcinoma. West China Medical Journal, 2013, 28(1): 53-55. doi: 10.7507/1002-0179.20130015 Copy

1.	黄志刚, 韩德民, 于振坤, 等. CO2激光手术治疗声门型喉癌疗效分析[J]. 中华耳鼻咽喉科杂志，2002, 37(3): 219-222.
2.	范献良, 张大良, 荣宝刚, 等. 显微喉镜CO2激光喉癌切除术的远期疗效观察[J]. 临床耳鼻咽喉科杂志, 2005, 19(18): 828-829.
3.	Ambrosch P. The role of laser microsurgery in the treatment of laryngeal cancer [J]. Curr Opin Otolaryngo Head Neck Surg, 2007, 15(2): 82-88.
4.	Vilaseca I, Bernal-Sprekelsen M, Luis Blanch J. Transoral laser microsurgery for T3 laryngeal tumors: prognostic factors [J]. Head Neck, 2010, 32(7): 929-938.
5.	Hinni ML, Salassa Jr, Grant DG, et al. Transoral laser microsurgery for advanced laryngeal cancer [J]. Arch Otolaryngol Head Neck Surg, 2007, 133(12): 1198-1204.
6.	Hafidh M, Tibbo J, Trites J, et al. Radiotherapy for T1 and T2 laryngeal cancer : the Dalhausie University experience [J]. J Otolaryngol Head Neck Surg, 2009, 38(4): 434-439.
7.	Peretti G, Piazza C, Cocco D, et al. Transoral CO(2) treatment for T(is)-T(3) glottic cancer: the University of Brescia experience on 595 patients [J]. Head Neck, 2010, 32(8): 977-983.
8.	Grant DG, Salassa JR, Hinni NL, et al. Transoral laser miscrosurgery for untreated glottic carcinoma [J]. Otolaryngol Head Neck Surg, 2007, 137(3): 482-486.
9.	吴娇娇，黄志刚，房居高，等. CO2激光手术治疗喉癌的并发症分析[J]. 中华耳鼻咽喉头颈外科杂志，2011, 46(2): 118-122.
10.	Beitler JJ, Muller S, Grist WJ, et al. Prognostic accuracy of computed tomography findings for patients with laryngeal cancer undergoing laryngectomy [J]. J Clin Oncol, 2010, 28(14): 2318-2322.
11.	Li B, Bobinski M, Gandour-Edwards R, et al. Overstaging of cartilage invasion by multidetector CT scan for laryngeal cancer and its potential effect on the use of organ preservation with chemoradiation [J]. Br J Radiol, 2011, 84(997): 64-69.
12.	于文斌, 曾宗渊, 陈福进, 等. T3-T4 期声门型喉癌颈淋巴结转移情况及其与预后的关系[J]. 癌症，2006，25(10): 1271-1274.
13.	Waldfahrer F, Hauptmann B, Iro H. Lymph node metastasis of glottic laryngeal carcinoma[J]. Laryngorhinootologie, 2005, 84(2): 96-100.
14.	李树玲．新编头颈肿瘤学[M]．北京：科学文献技术出版社，2002: 761-762.

1. 　黄志刚, 韩德民, 于振坤, 等. CO2激光手术治疗声门型喉癌疗效分析[J]. 中华耳鼻咽喉科杂志，2002, 37(3): 219-222.
2. 　范献良, 张大良, 荣宝刚, 等. 显微喉镜CO2激光喉癌切除术的远期疗效观察[J]. 临床耳鼻咽喉科杂志, 2005, 19(18): 828-829.
3. 　Ambrosch P. The role of laser microsurgery in the treatment of laryngeal cancer [J]. Curr Opin Otolaryngo Head Neck Surg, 2007, 15(2): 82-88.
4. 　Vilaseca I, Bernal-Sprekelsen M, Luis Blanch J. Transoral laser microsurgery for T3 laryngeal tumors: prognostic factors [J]. Head Neck, 2010, 32(7): 929-938.
5. 　Hinni ML, Salassa Jr, Grant DG, et al. Transoral laser microsurgery for advanced laryngeal cancer [J]. Arch Otolaryngol Head Neck Surg, 2007, 133(12): 1198-1204.
6. 　Hafidh M, Tibbo J, Trites J, et al. Radiotherapy for T1 and T2 laryngeal cancer : the Dalhausie University experience [J]. J Otolaryngol Head Neck Surg, 2009, 38(4): 434-439.
7. 　Peretti G, Piazza C, Cocco D, et al. Transoral CO(2) treatment for T(is)-T(3) glottic cancer: the University of Brescia experience on 595 patients [J]. Head Neck, 2010, 32(8): 977-983.
8. 　Grant DG, Salassa JR, Hinni NL, et al. Transoral laser miscrosurgery for untreated glottic carcinoma [J]. Otolaryngol Head Neck Surg, 2007, 137(3): 482-486.
9. 　吴娇娇，黄志刚，房居高，等. CO2激光手术治疗喉癌的并发症分析[J]. 中华耳鼻咽喉头颈外科杂志，2011, 46(2): 118-122.
10. 　Beitler JJ, Muller S, Grist WJ, et al. Prognostic accuracy of computed tomography findings for patients with laryngeal cancer undergoing laryngectomy [J]. J Clin Oncol, 2010, 28(14): 2318-2322.
11. 　Li B, Bobinski M, Gandour-Edwards R, et al. Overstaging of cartilage invasion by multidetector CT scan for laryngeal cancer and its potential effect on the use of organ preservation with chemoradiation [J]. Br J Radiol, 2011, 84(997): 64-69.
12. 　于文斌, 曾宗渊, 陈福进, 等. T3-T4 期声门型喉癌颈淋巴结转移情况及其与预后的关系[J]. 癌症，2006，25(10): 1271-1274.
13. 　Waldfahrer F, Hauptmann B, Iro H. Lymph node metastasis of glottic laryngeal carcinoma[J]. Laryngorhinootologie, 2005, 84(2): 96-100.
14. 　李树玲．新编头颈肿瘤学[M]．北京：科学文献技术出版社，2002: 761-762.

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West China Medical Journal

A Preliminary Study of CO2 Laser Surgery and Open Partial Laryngectomy in Treating T3 Glottic Laryngeal Carcinoma

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