Powikłania leczenia wczesnego raka głośni za pomocą lasera CO2
Journal Title: Otolaryngologia Polska - Year 2011, Vol 65, Issue 5
Abstract
SUMMARY Introduction: CO2 laser endoscopic surgery, introduction in the treatment of early glottic malignancies in the early seventies is the method has been well-studied in such cases, and its utility for these lesions is well-established. Transoral resection with the CO2 laser, open partial laryngectomy and radiotherapy are the main options for treatment of early laryngeal cancer. As all the therapies are all equally effective in controlling an early glottic cancer the choice of treatment must consider such factors as possible complications, functional outcome and patient compliance. For properly selected patients the laser therapy provides equivalent oncologic outcomes when compared to traditional surgical therapies while improving the functional aspects of postoperative speech, voice and swallowing. Its advantages over open surgery include quicker recovery, less morbidity, fewer side effects and greater cost-effectiveness too. The disadvantages of radiotherapy are: duration of treatment, loss of time for work and social activities, higher rate of other possible complications, and partial preclusion of further conservative salvage surgery. Some authors report radiotherapy offers the better quality of voice but further investigations are needed to compare the voice following endoscopic resections with that obtained after radiotherapy. The aim of the study was to analyze the character of the peri- and postoperative complications after CO2 laser endoscopic surgery for the early glottis cancer. Matherial and methods: This was a retrospective study of a files of 55 pa-tients (7 female and 48 male) in age range 38-85 with early glottic carcinoma (Tis — T2) treated by cordectomy. Diagnosis was based on histopatological examination of the biopsy specimen of the lesion and ultrasonographical examination of the lymphonodules of the neck. Videolaryngostroboscopy and acustic analize of the voice was complicated. Ali of them underwent one of the types of cordectomy using a CO2 laser, between 2007 and 2010. Cordectomies were categorized according to the classification of the European Laryngological Society (2000 and rev. 2007). In our series most cordectomies were type III 24 patients. Type IV — 2 patients, type Va — 18, type Vb — 4, type Vc — 6 and type VI — 1 patient. We observed peri- and postoperative complication and functional result of the treatment such as quality of voice and swallowing difficulties. Results: Among 55 patient postoperative bleeding was the most commonly seen complication. It appeared in 34 of them (62%). All the cases of bleed-ing were easy to control. In 23 cases pain and mild laryngeal oedema were observed. It resolved in 3-4 day after medical treatment. None of our patient required tracheotomy. Eight patients needed revision procedures: four due to granulation tissue formation, two due to adhesion and another two due to laryngocele.
Authors and Affiliations
Antoni Bruzgielewicz, Ewa Osuch-Wójcikiewicz, Paweł Szwedowicz, Grzegorz Januszek, Anna Domeracka-Kołodziej, Renata Zawadzka, Kazimierz Niemczyk
Keywords
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