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中华口腔医学研究杂志(电子版) ›› 2016, Vol. 10 ›› Issue (06) : 408 -413. doi: 10.3877/cma.j.issn.1674-1366.2016.06.008

所属专题: 文献

临床研究

内镜辅助下经颅耳沟切口行腮腺良性肿瘤包膜外切除术
李群星1, 范松1, 张汉卿1, 谢舒乐1, 陈伟雄1, 潘国凯1, 李劲松1,()   
  1. 1. 510120 广州,中山大学孙逸仙纪念医院口腔颌面外科
  • 收稿日期:2016-10-14 出版日期:2016-12-01
  • 通信作者: 李劲松

Endoscope-assisted extracapsular dissection of benign parotid tumors through a single cephaloauricular furrow incision versus a conventional approach

Qunxing Li1, Song Fan1, Hanqing Zhang1, Shule Xie1, Weixiong Chen1, Guokai Pan1, Jinsong Li1,()   

  1. 1. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
  • Received:2016-10-14 Published:2016-12-01
  • Corresponding author: Jinsong Li
  • About author:
    Corresponding author: Li Jinsong, Email:
引用本文:

李群星, 范松, 张汉卿, 谢舒乐, 陈伟雄, 潘国凯, 李劲松. 内镜辅助下经颅耳沟切口行腮腺良性肿瘤包膜外切除术[J]. 中华口腔医学研究杂志(电子版), 2016, 10(06): 408-413.

Qunxing Li, Song Fan, Hanqing Zhang, Shule Xie, Weixiong Chen, Guokai Pan, Jinsong Li. Endoscope-assisted extracapsular dissection of benign parotid tumors through a single cephaloauricular furrow incision versus a conventional approach[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2016, 10(06): 408-413.

目的

探讨一种内镜辅助下经颅耳沟切除腮腺良性肿瘤的方法。

方法

60例腮腺浅叶良性肿瘤患者采用随机数字表法分成内镜组及传统手术组两组。统计并比较两组患者围手术期以及术后情况,包括肿瘤的最大直径、切口的长度、手术时间、术中出血量、术后引流量及引流时间,美观满意度,术后并发症及随访情况。利用SPSS 18.0进行数据的统计分析,采用t检验和卡方检验评价两组间的差异性。

结果

两组的肿瘤直径接近(t= 0.253,P= 0.234),所有的手术过程均按预期完成。内镜组平均切口长度(3.5 ± 0.4)cm小于传统手术组(9.0 ± 1.7)cm,差异有统计学意义(t= 16.645,P<0.001)。内镜组术中出血量(t= 16.028,P<0.001)、术后引流量(t= 6.499,P= 0.003)、围手术期并发症(χ2= 4.423,P= 0.035)以及外观效果(t= 16.285,P<0.001)均较传统手术组更好。术后随访10 ~ 40个月,无肿瘤复发。

结论

颅耳沟切口隐蔽,内镜辅助下应用颅耳沟切口行腮腺良性肿瘤包膜外切除术适用且可靠,可以缩小手术切口并能获得满意的美观效果。

Objective

To evaluate the feasibility of performing endoscope-assisted extracapsular dissections of benign parotid tumors using a single cephaloauricular furrow incision.

Methods

Sixty patients with benign parotid superficial lobe tumors were randomly divided into two groups: an endoscope-assisted (27 patients) group and conventional (33 patients) surgery group. Perioperative and post-operative outcomes of the patients were evaluated, including the maximum diameter of the tumors, length of the incision, operating time, estimated blood loss during the operation, amount and duration of drainage, satisfaction scores based on the cosmetic results, perioperative complications, and follow-up information.

Results

The diameters of the tumors were comparable between the groups (t= 0.253, P= 0.234) , and all operations were successfully performed as planned. The mean length of the incision in the endoscope-assisted group (3.5 ± 0.4) cm was significantly shorter than the conventional group (9.0 ± 1.7) cm (t= 16.645, P<0.001) . Meanwhile, the intraoperative blood loss (t= 16.028, P<0.001) , amount of drainage (t= 6.499, P= 0.003) , perioperative complications (χ2= 4.423, P= 0.035) and cosmetic outcomes (t= 16.285, P<0.001) were all improved in the endoscope-assisted group (P<0.05) . No tumor recurrence was found during 10-40 months of follow-up. Student′s t tests and chi-squared tests were used for the comparisons between the two groups. Statistical analyses were performed using the SPSS 18.0 package, and a P-value of <0.05 was considered to indicate statistical significance.

Conclusions

Cephaloauricular furrow incisions were totally and naturally hidden in this procedure. Endoscope-assisted extracapsular dissections of benign parotid tumors via a small cephaloauricular furrow incision was found to be feasible and reliable, providing a minimally invasive approach and a satisfactory appearance.

图1 经颅耳沟切口行腮腺良性肿瘤包膜外切除术术前影像学检查、切口设计及术后随访
图2 内镜辅助下经颅耳沟切口行腮腺良性肿瘤包膜外切除术步骤
图3 颅耳沟切口设计及手术区域建立,可以覆盖整个腮腺区域
表1 60例腮腺浅叶肿瘤手术患者临床资料及数据分析结果
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