부산대학교 도서관

Endoscopic laryngo-pharyngeal surgery (ELPS) is a transoral surgery for superficial laryngopharyngeal carcinoma. At our hospital, we use a curved rigid laryngoscope to expand the laryngo-pharyngeal cavity and then an endoscopist examines the lesion with a magnifying endoscope. Next, a head and neck surgeon resects the lesion using a tip- movable high-frequency knife. During resection, the endoscopist locally injects physiological saline via the forceps port of the endoscope using a needle, with the objective of lifting the area surrounding the lesion and submucosa. In some cases, he/she may also assist the surgeon by making incisions in the mucosa and submucosa. Therefore, coordination between the head and neck surgeon and endoscopist is important. We conducted a short-term, retrospective study of the performance of ELPS at our hospital, by investigating 50 instances of its use in 57 superficial head and neck cancer lesions in 40 patients from August 2014 to December 2017. Regarding the locations of the primary cancers, 43 were in the hypopharynx, 7 in the oropharynx and 7 in other locations. The mean resection time per lesion was 59 minutes, and histopathologically, the numbers of resection margins determined to be pHM0, pHM1 and pHMX were 27, 16 and 14, respectively, and the numbers of resection margins determined as pVM0 and pVM1 were 56 and 1, respectively. The median time to resumption of oral intake was one day. Tracheotomy was needed postoperatively in 2 patients, because of marked laryngeal edema in one case and aspiration in the other. There was local recurrence in 3 patients, recurrence in the cervical lymph nodes in 4 patients, and 2 died of other diseases; all the other patients continue to be cancer-free. Thus, good outcomes are achieved with ELPS at our hospital through coordination with endoscopists.