微创手术治疗早期声门型喉癌及癌前病变的近期疗效观察

目的：观察分析微创手术治疗早期声门型喉癌及癌前病变的近期疗效。方法选取2012年1月~2013年1月于本院治疗的90例早期声门型喉癌及癌前病变患者。其中33例进行传统喉裂开切除，将其定为A组，37例进行CO2激光切除术，将其定为B组，20例进行低温等离子射频消融术，将其定为C组。90例患者在进行手术后，均进行门诊复查电子喉镜，并进行电话随访。结果从早期声门型喉癌患者的手术时间上看，C组平均为（8.74±1.52）min，B组平均为（14.91±1.74）min，A组平均为（121.16±5.31）min。C组优于B组，B组和C组均优于A组（P＜0.05）。从患者黏膜恢复情况上看，C组中12例为光滑，1例为不光滑；B组中4例为光滑，7例为不光滑；A组中15例为光滑，18例为不光滑，B组和A组间无明显差异， C组明显优于B组和A组（P＜0.05），从患者24个月内复发情况上看，喉癌组中，11例低温等离子术患者均未有复发。13例CO2激光切除术患者中，1例复发，癌前病变组中，8例低温等离子术患者均未有复发。25例CO2激光切除术患者中，2例复发。结论在早期声门型喉癌及癌前病变的治疗中，可采用微创手术治疗，其手术切割准确且出血少，术后风险较小、术后并发症较少，并且恢复时间短，具有重要临床应用价值。

Recent curative effect of minimally invasive surgery in treatment of early glottic cancer and precancerous lesions

Objective To analyze the recent curative effect of Minimally invasive surgery in treatment of Early glottic cancer and precancerous lesions. Methods 90 patients with early glottic cancer and precancerous lesions in our hospital between January 2012 and January 2013 were collected. 33 cases received conventional split throat surgery, which was designated as Group A; 37 cases accepted CO2 laser surgery, which was designated as Group B;20 cases accepted radiofrequency ablation, which was designated as Group C. After surgery, 90 patients underwent outpatient review electronic laryngoscope, and telephone follow-up. Results The mean operation time of Group C was （8.74±1.52）min, Group B was （14.91±1.74）min, Group A was（121.16±5.31）min. Group C was better than the group B, group B and group C were better than group A （P 〈 0.05）. The Mucosal recovery of the 3groups were observed, 12 cases in group C were smooth,1 non-smooth, Group B with 4 smooth and 7 non-smooth group A with 15 smooth and 18 non-smooth, group B and group A had no significant difference, group C was significantly better than group B and group A （P〈0.05）; Recurrence within 24 months was observed, 11 cases of laryngeal cancer group patients undergoing low-temperature plasma no recurrence. 13 cases of CO2 laser surgery patients, 1 case of recurrence;precancerous lesion group, 8 cases of low-temperature plasma in patients undergoing no recurrence. 25 cases of CO2 laser surgery patients, 2 cases of recurrence. Conclusion Minimally invasive surgery can treat early glottic cancer and precancerous lesions,and has surgical cutting accurate, less bleeding, less postoperative risk, fewer complications, shorter recovery time, has important clinical value.