使用一次性内窥镜进行诊室喉部手术的表现

文献信息

中文摘要

目的： 近年来，由于设备进步和降低医疗成本的努力等多方面因素，诊室喉部手术有所扩展。一次性内窥镜主要在住院环境中被采用，与可重复使用设备相比具有多项优势，包括更低的资本投资以及消除再处理和维修成本。本研究调查了一次性内窥镜在诊室喉部手术中的表现。
方法： 在单一机构对使用一次性带通道内窥镜接受诊室喉部手术的患者进行回顾性审查。回顾性收集了包括人口统计学、病理、设备、治疗结果和不良事件在内的数据。
结果： 纳入了24名在2023年10月至2024年4月期间接受诊室蓝光激光或活检手术的患者。在七例完成的活检中，六份标本（85.7%）足以用于诊断；没有并发症。进行了21例激光手术，其中20例成功完成。一名患者耐受性差，需要提前终止。有2例轻微术后不良影响（11.1%），包括呼吸困难和头痛。治疗的病理包括喉乳头状瘤（44.4%）、声带息肉（27.8%）、异型增生（16.7%）、冗余杓状/环后黏膜（11.1%）、血管扩张（16.7%）和角化过度（5.56%）。激光输出范围为9至289焦耳。十名患者病变消退（55.6%），4名疾病负担减轻（22.2%），2名疾病稳定（11.1%），1名疾病进展（5.56%）。一名患者失访。
结论： 使用一次性内窥镜进行诊室喉部手术是可行的，其结果可接受，与标准治疗一致。这种治疗方式可能改善无法获得可重复使用设备的中心的治疗可及性，并可能提高喉部疾病治疗的效率。

英文摘要

OBJECTIVES: In-office laryngeal procedures have expanded in recent years due to several factors, including advances in equipment and efforts to reduce health care costs. Single use endoscopes have been adopted primarily in the inpatient setting and offer several advantages over reusable equipment, including lower capital investment and the elimination of costs of reprocessing and repairs. This study investigates the performance of single use endoscopes for in-office laryngeal procedures.
METHODS: A retrospective review at a single institution of patients who underwent in-office laryngeal procedures using single-use channeled endoscopes. Data including demographics, pathology, equipment, treatment outcomes, and adverse events were collected retrospectively.
RESULTS: Twenty-four patients who underwent in-office blue light laser or biopsy procedures between 10/2023 and 4/2024 were included. Among seven completed biopsies, six specimens (85.7%) were adequate for diagnosis; there were no complications. Twenty-one laser procedures were performed, with 20 successfully completed. One patient had poor tolerance requiring early termination. There were 2 minor post-procedural adverse effects (11.1%), including dyspnea and headache. Pathologies treated included laryngeal papilloma (44.4%), vocal fold polyps (27.8%), dysplasia (16.7%), redundant arytenoid/postcricoid mucosa (11.1%), vascular ectasias (16.7%), and hyperkeratosis (5.56%). Laser output ranged from 9 to 289 Joules. Ten patients had resolution of lesion(s) (55.6%), 4 had reduction in disease burden (22.2%), 2 had stable disease (11.1%), and 1 had disease progression (5.56%). One patient was lost to follow-up.
CONCLUSION: In-office laryngeal procedures using single-use endoscopes are feasible, with acceptable outcomes which align with standard of care. This treatment modality may improve access to centers where reusable equipment is not available, and may improve efficiency in the treatment of laryngeal disorders.