Article
Endoscopic CO2 Laser for supraglottic carcinoma with postoperative iradiation
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Published: | April 14, 2014 |
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In 1996 in the ENT Department Timişoara we started the first laser CO2 endoscopic operation, introducing this method in clinical practice in our country.
This study presents the indications,general principles,contraindications,limits and results of this modern therapeutic method.Open surgical procedures,primary radiotherapy and endoscopic procedures are the therapeutic alternatives,with or without neck dissection and adjuvant radiotherapy.
Method: Between 1996–2006 27 patients with supraglottic carcinoma T1 or T2 and N0, have been treated with supraglottic laryngectomy with CO2 Laser.Carefull preoperative selection is of outmost importance for the clinical outcome of patients.In the studied group we applied simple epiglotectomy – 8 cases, extended epiglotectomy – 12 cases, HSL (horizontal supraglottic laryngectomy) – 7 cases.
Postoperative follow-up was between 12–48 months, average 36 months.
Tracheotomy was not considered necessary.Naso-gastric feeding tube was necessary in only two cases for a few days postoperative (patients with HSL)
Results: In our group we obtained the following oncological results: no evidence of disease (NED) – 24 cases (88,9%) and local reccurrence in 3 cases (11,1%).All patients who presented local reccurrence in larynx were in stage T2 N0 of the disease; the salvation treatment we applied consisted in total laryngectomy. Immediate functional results were very good in all cases.
Conclusion: Endosocopic CO2 laser microsurgery appears to be an effective and safe alternative treatment for T1-T2, N0 supraglottic carcinoma, with superior oncologic and functional results than the other techniques, requiring short hospitalization, no tracheostomy and feeding tube and providing superior rehabilitative result with a good quality of life.
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