Biopsy of Advanced Hypopharyngeal Carcinoma under Video Laryngeal Telescopic Guidance: An Office Based Procedure

硬式喉鏡影像錄影系統引導下於門診執行晚期下咽癌患者切片之結果

江裕群(Yuh-Chyun Chiang) ； 黃鈞鼎(Chun-Ding Huang) ； 李飛鵬(Fei-Peng Lee) ； 薛如茵(Ju-Yin Hsueh) ； 許信德(Hsin-Te Hsu) ； 趙品植(Pin-Zhir Chao) ； 楊宗翰(Tsung-Han Yang)

《台灣耳鼻喉頭頸外科雜誌》 45卷2期 (2010/04) Pp. 54-58

https://doi.org/10.6286/2010.45.2.54

摘要

背景：下咽癌因臨床症狀不明顯，患者於就診時往往已是晚期。這一類下咽癌的患者爲確立診斷，傳統需要在全身麻醉下，接受直接喉鏡的切片手術；如此常併有呼吸道阻塞的風險。本研究提出在硬式喉鏡影像監視系統的引導下，於門診局部麻醉，執行晚期下咽癌患者切片之方法與結果。
材料及方法：本研究收集自2003至2007年，於台北醫學大學附設醫院耳鼻喉科門診，臨床上懷疑晚期下咽癌之患者計13名〈均爲男性〉，年齡分布45至72歲，平均57.5歲。於門診局部麻醉，在硬式喉鏡影像錄影系統引導下，以鼻竇內視鏡用彎鉗，執行下咽可疑患處之切片手術。
結果：13名臨床上懷疑晚期下咽癌之患者，除1名因就診時已出現呼吸窘迫現象，安排接受緊急氣管切開手術外，其餘12名臨床上懷疑晚期下咽癌之患者，均於當次門診順利完成切片手術，所採集之病理檢體證實均爲鱗狀上皮癌。
結論：臨床上懷疑晚期下咽癌的患者，經過適當的篩選，以硬式喉鏡影像錄影系統引導，於門診局部麻醉執行切片手術，是簡單安全，且具有效率的方法。

關鍵字

門診切片 ； 硬式喉鏡與影像錄影系統 ； 晚期下咽癌

並列摘要

OBJECTIVE: The study goal was to present the technique and results of office-based biopsy of advanced carcinoma in the hypopharynx under video laryngeal telescopic guidance.
STUDY DESIGN AND SET: From 2003 to 2007, a total of 13 patients with clinical suspicion of advanced carcinoma in the hypopharynx were studied at the ENT Department of Taipei Medical University Hospital. RESULT: All but one patient were biopsied smoothly with adequate amount of specimens for definite pathologic diagnosis at the time of initial clinical examination.
CONCLUSION: In select patients, biopsy of advanced hypopharyneal carcinoma under video laryngeal telescopic guidance can be performed smoothly in an office-based setting. The technique has also proven to be efficient, well tolerated, and with low morbidity.
SIGNIFICANCE: Biopsy of advanced hypopharyneal carcinoma with this technique can reduce the use of direct laryngoscope under general anesthesia, which obviates surgery-related morbidity. This technique is both clinically and financially effective.

並列關鍵字

office-based biopsy ； video laryngeal telescope ； advanced hypopharyngeal carcinoma