协和医学杂志

2012, (02)

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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观察
Transoral Coblation Microsurgery (TCM)For head neck tumors

李五一

摘要(Abstract):

摘要:目的 探索经口低温等离子显微外科(TCM)治疗头颈肿瘤。 方法 回顾性分析2008年5月至2011年10月,我院93例TCM手术资料。包括T1-2喉癌43例,喉良性肿瘤14例,口咽和喉咽恶性肿瘤10例,咽和咽旁间隙良性肿瘤17例和9例。11例为开放手术或CO2激光手术后局部复发病例。结果 93例均达到内窥镜全切除标准。3例咽癌同期行颈清扫术。18例T2喉癌和咽癌术后辅助放疗。术后并发症:迟发型出血共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:喉癌:无失访,随访2-40月(中位时间14.5月),局部复发2例,行环上喉切除和全喉切除挽救手术,术后随访24月和15月,无瘤生存。咽恶性肿瘤随访6-40月(中位随访时间19月),1例失访,其余无瘤生存;喉、咽和咽旁间隙良性肿瘤:无失访,随访2-37月(中位时间17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T1-2的早期恶性头颈肿瘤治疗。
【Abstract】 Objective To present the experience of Transoral Coblation Microsurgery (TCM)for head neck tumors. Methods. A review of 93 patients treated with TCM at Peking Union Medical College Hospital from May 2008 to Oct 2011 . There were 43 patients with T1-2 laryngeal cancer, 14 with laryngeal benign tumor,10 with malignant neoplasms and 17 benign tumor in the oro- hypopharynx, 9 benign tumor in the parapharyngeal space. 11 patients had recurrent primary tumors ,who underwent endoscopic or open-neck resections。 Results Total resection endoscopically was achieved in all the patients. 3 patients had neck dissections, and 18 patients with T2 laryngeal cancer or oro- hypophargeal cancer received adjuvant radiotherapy. The complications was minor, include 3 postoperative hemorrhage, 2 subcutaneous emphysema, 4 dehiscence of the pharyngeal wounds, 10 laryngeal web or granulation. laryngeal cancer were follow up 2-40 months(median 14.5 months), 2 patients local recurred . Pharyngeal malignant neoplasms were follow up 6-40 months(median 19 months),1 patients was lost and others were disease-free. Benign tumor in larynx、pharynx and the parapharyngeal space were follow up 2-37 months(median 17 months), 3 patients with laryngeal papilloma local recurred . Conclusions Transoral Coblation Microsurgery (TCM) is a safe and effective treatment alternative for select early malignant neoplasms or benign tumor of head and neck .

关键词(KeyWords): |经口微创手术|低温等离子|头颈肿瘤| 喉| 咽|咽旁间隙|并发症|
|Transoral microsurgery| Coblation|Head and neck neoplasms|larynx|pharynx|parapharyngeal space|complication|

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作者(Author): 李五一

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