Co-treatment with endoscopic laryngopharyngeal surgery and endoscopic submucosal dissection
Co-treatment with endoscopic laryngopharyngeal surgery and endoscopic submucosal dissection
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DOI：
10.1016/j.anl.2020.10.003
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发表时间：
2021-04-08
影响因子：
1.7
通讯作者：
Itoi, Takao
中科院分区：
文献类型：
--
作者：
Yamaguchi, Hayato;Sato, Hiroki;Itoi, Takao
目的：内镜下咽喉部手术是治疗咽部恶性肿瘤的一种有效的微创方法。然而，ELPS的缺点是手术区域的仪器干扰以及难以接近某些区域。为了克服这些缺点，我们开始进行ELPS和内镜粘膜下剥离术（ESD）的联合治疗。本研究的目的是比较ELPS单独治疗和ELPS联合ESD治疗的疗效。方法：对2014年8月至2020年1月在我院接受咽部ELPS治疗的73例浅表性咽癌患者的103个病灶进行分析。将病变分为单纯ELPS组和ELPS联合ESD组。对病变特征、技术结果、不良事件和长期结果进行了分析。在ELPS联合ESD组中，手术速度比单独ELPS组短（20.2 +/- 10.0 mm（2）/min vs 13.0 +/- 6.6 mm（2）/min，p < 0.001），R 0切除率更高（67.4% vs 45.6%，p = 0.027）。两组之间肿瘤大小、肿瘤浸润深度和不良事件无显著差异。这些结果在倾向评分匹配后保持不变。ELPS联合ESD组和ELPS单独组的3年总体和病因特异性生存率分别为96.7%和100%.Conclusions：ESD和ELPS联合治疗比ELPS单独治疗更有效的切除。胃肠病学家和头颈外科医生对咽癌患者的合作治疗是有效和有益的，并产生良好的长期结局。(C)2020日本耳鼻喉科学会Elsevier B. V.出版，保留所有权利。
Objective: Endoscopic laryngopharyngeal surgery (ELPS) is an effective and minimally invasive treatment for pharyngeal cancers. However, the disadvantages of ELPS are the interference of instruments in the operative field and the difficulty in approaching certain areas. To overcome these drawbacks, we began to perform combination treatment of ELPS and endoscopic submucosal dissection (ESD). The aim of the present study was to compare the efficacies of treatment with ELPS alone and ELPS combined with ESD.Methods: A total of 103 lesions in 73 patients who underwent pharyngeal ELPS for superficial pharyngeal cancer between August 2014 and January 2020 at our hospital were analyzed. Lesions were divided into the ELPS alone group and ELPS combined with ESD group. Lesion characteristics, technical results, adverse events, and long-term outcomes were analyzed.Results: In the ELPS combined with ESD group, procedure speed was shorter than the ELPS alone group (20.2 +/- 10.0 mm(2)/min vs 13.0 +/- 6.6 mm(2)/min, p < 0.001), and R0 resection rate was higher (67.4% vs 45.6%, p = 0.027). There were no significant differences in tumor size, depth of tumor invasion, and adverse events among the 2 groups. These results remained unchanged after propensity score matching. The overall and cause-specific survival rates at 3 years were 96.7% and 100% for the ELPS combined with ESD group and ELPS alone group, respectively.Conclusions: Combination treatment of ESD and ELPS enabled more efficient resection than ELPS alone. Cooperative treatment of pharyngeal cancer patients involving gastroenterologists and head and neck surgeons is effective and beneficial, and results in favorable long-term outcomes. (C) 2020 Oto-Rhino-Laryngological Society of Japan Inc. Published by Elsevier B.V. All rights reserved.