喉乳头状瘤黏膜下切除术后复发情况的初步临床探讨

胡慧英; 张庆翔; 孙国燕; 于振坤

doi:10.13201/j.issn.1001-1781.2015.21.008

喉乳头状瘤黏膜下切除术后复发情况的初步临床探讨

- 东南大学医学院附属南京同仁医院耳鼻咽喉头颈外科(南京, 211100)
基金项目:
江苏省临床重点专科建设项目(2013)

江苏省双创人才资助项目(2014)

详细信息

通讯作者: 于振坤,E-mail:yuzk@njtrh.org

中图分类号: R739.65

收稿日期: 2015-06-10

Treatment of recurrent laryngeal papilloma by submucosal resection and the effect on prognosis

- Department of Otolaryngology-Head and Neck Surgery, Nanjing Tongren Hospital Affiliated to Medical College of Southeast University, Nanjing, 211100, China

More Information

Corresponding author: YU Zhenkun, E-mail: yuzk@njtrh.org

Received Date: 10 June 2015

摘要

摘要: 目的: 探讨喉乳头状瘤CO₂激光黏膜下切除术对减少肿瘤复发的作用。方法: 11例复发性喉乳头状瘤患者术前均经纤维喉镜详细检查标记病变范围、部位,术中支撑喉镜下再进一步确认并详细记录。支撑喉镜下使用CO₂激光或喉科显微器械手术,完整切除肿瘤及肿瘤生长部位黏膜基底层以浅组织;病变广泛者术后7~10 d行创面假膜清理。手术标本(包括假膜)行常规病理、HPV病毒分型及免疫组织化学检查。术后3个月内每个月复查1次,以后每3个月复查1次,有声嘶或其他症状加重时随时复诊,病变复发者及时手术。结果: 标本HPV病毒检测显示HPV 11阳性7例,HPV 6阳性3例。随访6~12个月,1年内未见复发者3例;5例患者(包括2例儿童)经1次术后随访6个月以上未见复发;2例儿童患者经2~3次手术后缓解,随访6个月以上未见复发。结论: 喉乳头状瘤进行基膜以浅组织的切除术可减少术后复发,值得进一步临床探讨。
- 喉肿瘤 /
- 人乳头瘤病毒 /
- CO2激光 /
- 喉显微手术
Abstract: Objective: To investigate the efficacy of submucosal resection by CO₂ laser in the treatment of recurrent laryngeal papilloma and the effect on prognosis.Method: A total of 11 patients diagnosed as recurrent laryngeal papilloma were included in this review. Papilloma was marked before operation and checked under fibrolaryngoscope. Papilloma was resected completely including the submucosal tissure with CO₂ laser or microequipment. In widespread papilloma, false membrane in raw surface were cleared 7-10 days after operation. Surgical specimens (including membrane) were detected by routine pathology, HPV typing and immunohistochemical pathologic examination. The patients were checked once a month in the first 3 months after operation, and then once for every 3 months. Once the hoarseness and other symptoms aggravated or the disease was recurrent, the patients were treated immediately.Result: HPV viral DNA was found in 10/11 cases, with HPV11 (7/11 cases) and HPV6 (3/11 cases).Cases with regards to follow-up, from 6 months to 1 year, 3 cases were followed up 1 year after operation, without recurrence. Five patients including 2 children were followed up 6 to 12 months after operation, without recurrence. Two children underwent 2 or 3 operations, were followed-up more than 6 months withouting recurrence. Conclusion: Papilloma submucosal resection could decrease postoperative recurrence and is worth to be further investigated.
- laryngeal carcinoma /
- human papilloma virus /
- CO2laser /
- laryngeal microscopic operation

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