The Review Of Transoral Laser Microsurgery In Laryngeal Carcinoma

Objective: The thesis comprehensively reviewed the recent clinicalresearches on transoral laser microsurgery (TLM) in laryngeal carcinomaincluding history, status, basic procedure, effects, advantages, predictors ofoncologic outcome and prospects, to provide important clinical applicationvalue of TLM for the treatment of laryngeal carcinoma.Methods: Searched in PubMed, CBM, CNKI, VIP databases andcollected the literatures (including original article,meta-analysis and review)associated with TLM for laryngeal carcinoma between1971and2014.Search words in PubMed: laryngeal carcinoma/laryngeal squamous cellcarcinoma, laser surgery/transoral laser microsurgery. Search words inCBM, CNKI, VIP databases: glottic carcinoma/supraglottic carcinoma,laser surgery/CO2laser surgery/transoral laser microsurgery/endoscopicsurgery.Results: Many domestic and overseas literatures confirmed that TLMfor early golttic and supraglottic carcinoma avoids surgical complicationsand radiation complications.TLM is superior to other approches: safe,effective, low local recurrence rate, high laryngeal preservation, which realizes the minimally invasive surgical technology. More overseasliteratures reported in terms of the treatment of TLM in moderatelyadvanced glottic and supraglottic carcinoma,carcinoma of anteriorcommissure and salvage early recurrent laryngeal carcinoma afterradiotherapy or TLM. However, there are limited domestic literaturesreported, more have reported that the open surgical approaches is still themain treatment of laryngeal carcinoma.Conclusions: Current practice standards for the treatment of laryngealcarcinoma demand both achievement of cure and preservation of laryngealstructure and function to the greatest extent possible. The oncologic andfunctional results of TLM for early glottic carcinoma appear to becomparable to those of radiotherapy, with a higher rate of laryngealpreservation and a lower cost. TLM for early and moderately advancedsupraglottic carcinoma offers similar results with regard to survival andlocal control to those obtained with open surgical approaches. In addition,functional results of TLM are superior to those of open approaches becausetracheotomies are usually avoided, rehabilitation of swallowing is faster,and hospital stay is shorter. TLM, when applicable, has become thepreferred modality for surgical treatment of most early to moderatelyadvanced laryngeal carcinoma. TLM may be a curative organ-preservingtreatment for anterior commissure laryngeal carcinoma, salvage earlyrecurrent laryngeal carcinoma after radiotherapy or TLM. TLM combined with transoral robotic surgery and cryotherapy will be accepted as a morevaluable therapeutic option for laryngeal carcinoma.