CO2激光喉显微手术治疗早期声门型喉癌疗效观察及相关因素分析

目的探讨CO2激光喉显微手术治疗早期声门型喉癌的疗效和安全性，对手术注意事项进行探讨。方法在显微支撑喉镜下，对27例早期声门型喉癌患者采用CO2激光手术治疗，其中Tis6例，T1a8例，T1b7例，T26例。累及前联合者3例，未累及前联合者24例。结果全部患者CO2激光手术均成功，术后无一例患者出现呼吸困难、出血等严重并发症。随访3年以上，存活率100％。2例患者复发，其中1例行CO2激光喉显微手术再切除，1例行喉垂直部分切除并术后放疗，随访2年均未再复发。结论CO2激光喉显微手术是治疗早期声门型喉癌的有效方法，通过选择合适的患者及注意术中操作，可减少甚至避免显微喉镜激光手术引起的声带粘连。

Therapeutic effect of CO2 laser phonomicrosurgery for early glottic carcinoma

Objective To investigate the efficacy of CO2 laser phonomicrosurgery for early glottic carcinoma, and to explore the important notes about this surgery. Methods 27 patients with early glottic carcinoma received CO2 laser phonomicrosurgery. As for the T stages of the tumor, there were 6 cases at Tis stage, 8 cases at T1 a stage, 7 cases at T1 b stage and 6 cases at T2 stage. The anterior commissure was involved by tumor in 3 of the 27 cases. Results All patients were treated with CO2 laser phonomicrosurgery successfully. No severe complications such as dyspnea and hemorrhage occurred. Being followed up for more than 3 years postoperatively, all patients survived with local recurrence in 2 cases. Of these two, one underwent CO2 laser treatment again, and the other underwent vertical partial laryngectomy combined with postoperative radiotherapy. No local recurrence was found in both cases until the last follow-up. Conclusions CO2 laser phonomicrosurgery is effective and minimally invasive for the treatment of the early glottic carcinoma. With appropriate selection of the patients and careful notice of the surgical skills, the adhesion of vocal cords may be reduced or even be avoided.