显微喉镜CO_2激光手术治疗喉癌

为进一步探讨显微喉镜下 Ｃ Ｏ２ 激光手术治疗喉癌的适应证、禁忌症、手术方法、注意事项及手术效果，对 ２０ 例喉癌患者在支撑喉镜下行 Ｃ Ｏ２ 激光显微手术，其中会厌癌 １ 例（ Ｔ１ Ｎ０ Ｍ ０），声门癌 １９ 例（ Ｔｉｓ ２ 例、 Ｔ１ Ｎ０ Ｍ ０ １６ 例、 Ｔ３ Ｎ０ Ｍ ０ １ 例）。５ 例行气管切开，１ 例行术前放疗，３ 例行术后放疗，术后患者恢复良好。平均住院时间 ２０３５±５．３９ｄ，较常规手术 ３０６±７３４ｄ 明显缩短（ Ｐ＜ ０．００１），无严重手术并发症发生。术后随访１３ 个月～４．５ 年，１ 例死于局部复发，１９ 例健在。术后发音好于常规手术。提示 Ｔ１ 声门区和声门上区喉癌适合显微喉镜 Ｃ Ｏ２ 激光手术，但 Ｔ２ 以上的喉癌不宜选用该手术。

LASER SURGERY FOR LARYNGAEL CARCINOMA UNDER MICROLARYNGOSCOPY

To explore the indications, contraindications, surgical techniques and experiences of laser surgery for laryngael carcinoma under microlaryngoscopy. Twenty cases of laryngeal cancer were treated by CO 2 laser under microlaryngoscopy. Nineteen of them were glottic cancers (Tis 2; T 1N 0M 0 16; T 3N 0M 0 1) and one was supraglottic (T 1N 0M 0). One case treated by radiotherapy before and three cases after operation. During 13 months to 4.5 years following up,except one case died of recurrence, 19 cases are alive without recurrent signs. T 1 glottic or supraglottic cancers are indications of laser surgery under micro laryngoscopy. T 2 and later lesions are not suitable for this method.