喉頭
Online ISSN : 2185-4696
Print ISSN : 0915-6127
ISSN-L : 0915-6127
パネルディスカッション1 「高齢者喉頭癌の治療戦略」
高齢者喉頭癌の治療戦略 -経口的手術の立場から-
宇野 光祐荒木 幸仁冨藤 雅之塩谷 彰浩
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2021 年 33 巻 02 号 p. 114-119

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This study examined the feasibility of carbon dioxide (CO2) transoral laser microsurgery (TLM) for early glottic carcinoma in Japanese patients over 75 years old. A retrospective chart review was performed for 43 patients with (r)Tis-T2 glottic cancer who underwent TLM in our institution between 2010 and 2018. The oncological results, postoperative voice/swallowing function, and complications were evaluated. Results show that TLM is a viable option for Tis and T1a cases when general anesthesia is possible. TLM appears to be appropriate for T1b lesions that are clear and localized. However, if type Ⅵ cordectomy is required, prolonged hospitalization owing to aspiration may occur. T2 carcinomas with unclear lesion extension may require salvage treatment. In salvage cases, TLM should be carefully considered according to the extent of lesion progression at the time of the initial treatment and postoperative complications. The postoperative voice function was found to be equivalent to that observed after radiation therapy, and approximately 80% of patients were able to start oral intake the day after surgery. TLM is minimally invasive and requires a short hospital stay, making it an attractive treatment option for elderly patients. Furthermore, actively performing transoral surgery in elderly patients should be encouraged.

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