| Background Laryngeal cancer is a common malignancy in otorhinolaryngology. Its morbidity has increased in recent years, which is related to smoking, drinking, environmental pollution. 96% to 98% of laryngeal cancer is squamous cell carcinoma. According to the lesion and extent of disease, the laryngeal divided into the following four types: 1. Supraglottic cancer(including fringe); 2. Glottic cancer; 3. Subglottic cancer; 4. Transglottic cancer, this type of cancer remains controversial, the International Union Against Cancer(Union for intemational cancer control, UICC) organization has not yet been confirmed. Glottic cancer(GC) is the most common type, accounting for 50% to 70%, which rarely occur neck and distant lymph node metastasis. With the growing awareness of the disease and the progress of various means of checking, early laryngeal is diagnosed easly. Therefore, early glottic carcinoma(Early glottic callcer, EGC) concept emerged: It is generally recognized that EGC is confined to supraglottic tissue anatomically, having not yet spread to the surrounding cartilage and muscle, no lymph node and distant metastasis; According to tumor staging,it contains Tis?T1a?T1b and part of T2. Early glottic callcer has main treatment methods :laser and radiation therapy. At present, many advocates preservation of laryngeal function in a single discipline therapy. With the change biomedical model to bio-psycho-social medical model, the survival rate is no longer the sole criterion to measure the effect of treatment of laryngeal cancer, postoperative quality of life has becomed an important measure of treatment effect. Therefore, under the premise of ensuring the survival rate of patients,how to choice more effective treatment manner to improve the quality of life, it is the pursuit of Otolaryngology Head and Neck Surgeons, also the needs of patients. laryngofissure is a classical surgical operation, especially early glottic cancer, is reported 5-year survival rate of 90%. With the application of CO2 laser, low-temperature plasma technology, the throat of minimally invasive surgery becomes possible. Radiofrequency ablation is an emerging technology. Egger was first to put forward radiofrequency ablation that is a new soft tissue surgical technique in 1998,, After a few years,similar documents elaborated in depth and expand this technology into clinical. Since 2000, radiofrequency ablation have used to Otolaryngology Head and Neck Surgery, the new technology opened up a new world for the treatment of throat.Objective By comparing the two therapeutic schedules, it aims to explore minimally invasive treatment of early glottic laryngeal cancer.Methods 79 patients were selected,who suffered from the early glottic cancer during 2009-2012 in the department of otolaryngology head and neck surgery of the first affiliated hospital of Zhengzhou university.Among them 41 cases underwent radiofrequency ablation(radiofrequency group),while 38 cases underwent laryngofissure(laryngofissure group). Operative time, postoperative hospital stay, postoperative complications, postoperative mucosal recovery and recurrence rate were recorded and compared.ResultsThe operation time and postoperative hospital stay of radiofrequency group were shorter than laryngofissure group(P<0.05).The laryngofissure group had a faster musosal recovery(P<0.05).The local recurrence rate and the recurrence rate with anterior commissure involved were not statistically significant(P>0.05).But the rate of postoperative adhesion(p<0.05)were significantConclusion The radiofrequency ablation had a advantage in early glottic cancer,with less trauma,shorter hospital stay, lower recurrence rate and less postoperative complications. |
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