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颈动脉体副神经节瘤的外科治疗结果

Outcome of surgical treatment for carotid body paraganglioma.

作者信息

Plukker J T, Brongers E P, Vermey A, Krikke A, van den Dungen J J

机构信息

Department of Surgical Oncology/Head and Neck Surgery, University Hospital Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.

出版信息

Br J Surg. 2001 Oct;88(10):1382-6. doi: 10.1046/j.0007-1323.2001.01878.x.

Abstract

BACKGROUND

The present study reviewed a 30-year experience of managing carotid body paraganglioma (CBP) and analysed clinical findings associated with perioperative morbidity.

METHODS

Clinical records, radiological findings and pathological reports of all patients who presented with CBP between 1966 and 1997 were reviewed. There were 39 consecutive patients with 45 tumours and median follow-up was 10 years. The Shamblin classification was used to define complication rates and long-term surgical results.

RESULTS

Preoperative information derived from magnetic resonance angiography (MRA) and colour Doppler imaging (CDI) was comparable to that from standard four-vessel arteriography. Forty-one CBPs were resected in 35 patients. Six patients had bilateral tumours and seven had multicentric tumours. The median duration of operation and blood loss were substantially higher for Shamblin type III tumours. All major vascular complications (four of 39 patients) and permanent neurological complications (three of 39) were observed in type III tumours.

CONCLUSION

Surgical planning and prediction of perioperative complications can be obtained by staging derived from MRA and CDI. Severe complications occur predominantly in type III CBPs.

摘要

背景

本研究回顾了30年治疗颈动脉体副神经节瘤(CBP)的经验,并分析了与围手术期发病率相关的临床发现。

方法

回顾了1966年至1997年间所有出现CBP的患者的临床记录、影像学检查结果和病理报告。共有39例连续患者,45个肿瘤,中位随访时间为10年。采用沙姆林分类法定义并发症发生率和长期手术结果。

结果

磁共振血管造影(MRA)和彩色多普勒成像(CDI)获得的术前信息与标准四血管动脉造影的信息相当。35例患者切除了41个CBP。6例患者为双侧肿瘤,7例为多中心肿瘤。沙姆林III型肿瘤的中位手术时间和失血量明显更高。所有主要血管并发症(39例患者中的4例)和永久性神经并发症(39例中的3例)均在III型肿瘤中观察到。

结论

通过MRA和CDI进行分期可获得手术规划和围手术期并发症的预测。严重并发症主要发生在III型CBP中。

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