Abstract

Goal: to improve the intraoperative visualization of tumour lesions of the larynx for the purpose of organ-preserving operations.

Material and methods: 110 patients with laryngeal cancer who underwent surgical treatment at the first stage from 2015 to 2023 were under observation. All patients underwent fibrolaryngoscopy to objectively determine the border of the tumour lesion with white light and CT scan before the operation as an initial diagnosis and intraoperative diagnosis with 2% toluidine blue to perform as a final visualization of the border of the tumour lesion. Patients underwent organ-sparing surgical treatment with organ preservation in the form of various variants of laryngeal resection.

Results: Long-term results of surgical treatment were assessed 6 months or more after surgical treatment. The volume of organ-sparing surgical operations depended on the degree and intensity of tissue staining in blue. Morphological examination of both zones showed the absence of neoplastic cells in the tissues stained in light blue and confirmed the cancer process in the zone stained in dark blue.

Observation of patients for 6 months, 2 and 5 years showed the absence of prolongation and recurrence of laryngeal cancer. But 11 (10%) patients were diagnosed with recurrence in the lymph nodes of the neck after 5.5 years, which was 10%.

Conclusions

1. The introduction and use of 2% toluidine blue intraoperatively made it possible to accurately visualize the borders of the tumour cancerous lesion and the elements of invasion based on the degree of blue colour and to carry out radical organ-sparing surgical treatment in 100% of patients.
2. Recurrence of laryngeal cancer in the lymph nodes was diagnosed 5.5 years after surgical treatment in 10% of patients.

Key words: malignant neoplasms of the larynx and other ENT organs, diagnostic technique, colour-defined tumour lesion, organ-preserving surgical treatment.