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首页> 外文期刊>Journal of otolaryngology - head & neck surgery = >Review of transoral laser microsurgery for cancer of the upper aerodigestive tract.
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Review of transoral laser microsurgery for cancer of the upper aerodigestive tract.

机译：经口激光显微外科手术治疗上消化道消化道疾病的综述。

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OBJECTIVE: There is increasing evidence to support the role of transoral laser microsurgery (TLM) in treating cancers of the upper aerodigestive tract. The article summarizes our experience with TLM and reviews the evidence for TLM as a treatment modality for glottic, supraglottic, and oropharyngeal cancers. Functional results, the role of margins, and postoperative complications are also discussed in relation to TLM. METHODS: MEDLINE reviews were performed to identify experimental or observational studies of outcomes for upper aerodigestive tract cancers treated by TLM. The references of relevant articles were used to identify any studies not detected by initial searches. RESULTS: Over 300 articles were identified relating to outcomes in upper aerodigestive tract cancers treated with TLM. The overwhelming majority of these articles are observational rather than experimental studies. CONCLUSIONS: The efficacy of TLM has been demonstrated for a broad spectrum of upper aerodigestive tract cancers. The best evidence to date supporting TLM comes from prospective cohort series and retrospective cohort comparisons. In early glottic cancer, there is increasing evidence suggesting that a shift toward the use of TLM as the primary treatment modality is oncologically and functionally sound and will provide cost savings. There is significantly less evidence to promote the widespread use of TLM in advanced glottic, supraglottic, and oropharyngeal cancers. However, for indications where outcomes appear similar, the cost benefits of TLM combined with the ability to use radiation as a salvage modality make strong arguments in favour of using TLM as the primary modality.
机译：目的：越来越多的证据支持经口激光显微外科手术（TLM）在治疗上消化道疾病中的作用。本文总结了我们在TLM方面的经验，并回顾了TLM作为声门，声门上和口咽癌治疗方式的证据。还讨论了与TLM相关的功能结果，切缘的作用和术后并发症。方法：进行MEDLINE审查，以鉴定通过TLM治疗的上消化道癌症的结局的实验或观察性研究。相关文章的参考文献被用于识别任何最初搜索未发现的研究。结果：确定了300多篇与TLM治疗的上消化道癌预后相关的文章。这些文章中绝大多数是观察性研究，而不是实验性研究。结论：TLM的疗效已被证明可用于多种上消化道癌症。迄今为止，支持TLM的最佳证据来自前瞻性队列研究和回顾性队列比较。在早期的声门癌中，越来越多的证据表明，朝着将TLM用作主要治疗方式的转变在肿瘤学和功能上都是合理的，并且可以节省成本。很少有证据可以促进TLM在晚期声门，声门上和口咽癌中的广泛使用。但是，对于结果看起来相似的适应症，TLM的成本优势以及将放射线用作救助方式的能力提出了强有力的论据，赞成将TLM用作主要方式。

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