| 肖小玉.低温等离子射频切除术治疗早期声门型喉癌的长期疗效[J].浙江中西医结合杂志,2019,29(5): |
| 低温等离子射频切除术治疗早期声门型喉癌的长期疗效 |
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| 投稿时间：2018-07-30 修订日期：2018-09-26 |
| DOI： |
| 中文关键词: 低温等离子 射频切除术 早期喉癌 长期疗效 |
| 英文关键词:Low temperature plasma Radiofrequency resection Early laryngeal cancer Long-term efficacy |
| 基金项目: |
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| 摘要点击次数: 1305 |
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| 中文摘要: |
| 目的：探讨早期声门型喉癌低温等离子射频切除术的长期临床疗效。
方法：选取2011年1月至2014年6月就诊于上海交通大学附属第六人民医院耳鼻咽喉头颈外科20例早期声门型喉癌目的：探讨早期声门型喉癌低温等离子射频切除术的长期临床疗效。
方法：选取2011年1月至2014年6月就诊于上海交通大学附属第六人民医院耳鼻咽喉头颈外科20例早期声门型喉癌患者，均在全麻支撑喉镜下行低温等离子射频切除术,术中切缘冰冻病理检查。术后随访3年～6.5年。记录其手术时间、出血量、创面恢复时间、复发率及累计生存率。
结果：20例患者中男性18例，女性2例，平均年龄59.85岁（35岁～77岁），TNM分期：T1aN0M012例，T1bN0M04例及T2N0M04例。手术时间（45±18）分钟，术中出血约10～20ml。术后l周创面伪膜完全形成，术后l月左右伪膜脱落，少量肉芽形成，部分肉芽肿。术后2-3个月局部渐光滑，完成上皮化。1例随访3月发现左侧声带赘生物,行支撑显微喉镜下左侧声带病变切除术,术后病理为轻度不典型增生。1例随访10月后复发行气切十左侧垂直半喉切除术。1例随访6年后发现颈部淋巴结转移，余均未见肿瘤复发及转移。局部复发率为10%（2/20），3年及5年累计生存率为100%。所有患者均未行气管切开，术后无出血、感染、呼吸困难等并发症。
结论：低温等离子射频消融技术具有喉功能保存好，手术时间较短，出血少，长期疗效较好等优点，是早期声门型喉癌微创治疗的良好选择。 |
| 英文摘要: |
| Objective: To explore the long term clinical effect of low temperature plasma radiofrequency excision of early glottic carcinoma.
Methods:20 patients were selected,who suffered from the early glottic carcinoma
during 2011.01-2014.6 in the department of Shanghai Jiaotong University Affiliated Sixth People''s Hospital ENT, In total anesthesia, the lower temperature plasma radiofrequency resection of the laryngoscope was performed. Postoperative follow-up was 3 years to 6.5 years. The time of operation, blood volume, recovery time, recurrence rate and cumulative survival rate were recorded.
Results: Among the 20 patients, 18 were males, 2 were females, and the mean age was 59.85 years old (35~77years old). TNM staging: 12 patients with T1aN0M0, 4 patients with T1bN0M0 and 4 patients with T2N0M0. Operation time (45±18) minutes, and intraoperative bleeding was from10ml to 20ml. After surgery one week, the pseudo membrane was formed completely, and the pseudo membrane came off one month or so after the operation and a small number of granulation was formed and some granulomas were found. 2-3 months after surgery local glottic portion gradually became smooth, got complete epithelialization. The vocal cord atypical hyperplasia was detected in one case 3 months after surgery. One patient was recurrence in larynx at postoperative 10 months followed with the left vertical half laryngectomy. After 6 years of follow-up, the cervical lymph node metastasis was found in one patient. No recurrence and metastasis were observed in other patients. The recurrence rate is 10% (2/20) and the cumulative survival rate is 100% in 3 years and 5 years. None of the patients underwent tracheal incision, and no complications such as bleeding, infection or breathing difficulties were performed after surgery.
Conclusion: Low temperature plasma radiofrequency ablation technology has several advantages of good laryngeal function, shorter operation time, less bleeding, and better long-term efficacy. It is a good choice for minimally invasive treatment of early glottic carcinoma. |
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