Objective: To explore the feasibility and efficacy of radiofrequency coblation assisted transoral surgery for the treatment of supraglottic laryngeal carcinoma by comparing with concurrent patients treated with conventional transcervical approach. To clarify the advantages of different surgical methods and to summarize the experience of supraglottic carcinoma radiofrequency ablation. Methods: Forty-six patients with supraglottic laryngeal carcinoma treated in department of otorhinolaryngology head and neck surgery, Peking University First Hospital from March 2014 to January 2021 were analyzed retrospectively. Among them(43 males, 3 females, aged from 45 to 79 years old), 23 patients were treated with radiofrequency coblation and 23 patients with partial laryngectomy with conventional transcervical approach. The operation time, intra-operative blood loss volume, recovery time, inpatient total medical cost and follow-up information of the two groups were analyzed. SPSS 26.0 software was used for statistical analysis. Results: There were no significant differences in age, gender, TNM staging,tumor staging and postoperative radiotherapy between the two groups (all P>0.05).The operation time, intra-operative blood loss volume, recovery time, inpatient total medical cost of the RFC-TOS group were110.0(60.0,150.0)min,5.0(5.0,30.0)ml,3.0(2.0,5.0)days,6.0(4.0,14.0)days and 26 100.7(16 145.5,47 044.4)yuan. The data of conventional transcervical approach group were 205.0(156.5,272.3)min, 150.0(50,200) ml, 18.0(16.3,22.8)days and 56520.1(440 992.5,67 109.9)yuan, (Z=-4.03, -4.94, -4.97, -4.98 and -4.13;all P<0.001).The 5-year local control rate, disease-specific survival rate and overall survival rate of the two groups were 86.96%,95.65%,91.30% and 86.96%,91.30%,73.90% renspectively, which had no significant difference between the two groups(all P>0.05). Conclusions: Compared with conventional transcervical surgeries, RFC-TOS could be a reliable new surgical option for organ-function preservation strategy in the treatment of supraglottic laryngeal carcinoma.The RFC is a suitable new technique and deserving more multi-center clinical trials for its clinical promotion.
目的： 探讨等离子射频辅助经口手术和开放喉部分切除术治疗声门上型喉癌的疗效和安全性。 方法： 回顾性分析2014年3月至2021年1月于北京大学第一医院耳鼻咽喉头颈外科手术治疗的46例声门上型喉癌患者临床资料（男43例，女3例，年龄45~79岁），其中行等离子射频辅助经口手术治疗23例（等离子组），经传统颈外入路行开放喉部分切除手术治疗23例（开放手术组）。观察2组患者手术时间、术中出血量、术后恢复经口进食时间、住院时长、住院费用及预后情况。应用SPSS 26.0进行统计学分析。 结果： 2组患者在年龄、性别、TNM分期、肿瘤分期、术后是否放疗方面差异均无统计学意义（P值均>0.05）。等离子组的手术时间、术中出血量、术后恢复经口进食时间、住院时长、住院费用分别为110.0（60.0，150.0）min、5.0（5.0，30.0）ml、3.0（2.0，5.0）d、6.0（4.0，14.0）d、26 100.7（16 145.5，47 044.4）元；开放手术组的上述指标分别为205.0（156.5，272.3）min、150.0（50，200）ml、18.0（16.3，22.8）d及5 6 520.1（440 992.5，67 109.9）元，2组差异有统计学意义（Z值分别为-4.03、-4.94、-4.97、-4.98、-4.13，P值均<0.001）。在预后方面，等离子组和开放手术组患者5年局部控制率、疾病特异性生存率、总体生存率分别为86.96%、95.65%、91.30%和86.96%、91.30%、73.90%。2组对比局部控制率、疾病特异性生存率和总体生存率差异无统计学意义（P值均>0.05）。 结论： 等离子射频辅助经口手术治疗声门上型喉癌对比开放手术在手术时间、术中出血量、术后恢复经口进食时间、住院时长、住院费用方面具有优势，预后和开放手术无明显差别，具有较好的应用前景。.