Seikaly Hadi, Jha Naresh, Harris Jeffrey R, Barnaby Pam, Liu Richard, Williams David, McGaw Timothy, Rieger Jana, Wolfaardt John, Hanson John
Division of Otolaryngology--Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
Arch Otolaryngol Head Neck Surg. 2004 Aug;130(8):956-61. doi: 10.1001/archotol.130.8.956.
Xerostomia is a permanent and devastating sequela of head and neck irradiation, and its numerous consequences affect most aspects of the patient's life. A new method of preserving and protecting a single submandibular gland from radiation damage through the Seikaly-Jha procedure (SJP) has recently been described.
To report the long-term outcomes of the SJP.
Inception cohort. Patients The trial was conducted between February 1, 1999, and February 1, 2002. All patients were followed up through the head and neck cancer clinic at the Cross Cancer Institute. All data were collected by a dedicated research nurse. Salivary function was evaluated at regular intervals with salivary flow studies and questionnaires.
Ninety-six patients were enrolled in the study, and 38 had a minimum of 2 years' follow-up. The cohort of 38 patients was composed of 2 groups: 26 patients had preservation of one submandibular gland through the SJP, while the remaining 12 did not. Salivary flow was preserved in the SJP group, in which 83% of patients reported normal amounts of saliva 2 years after radiotherapy, compared with none in the SJP group. There were no disease recurrences on the side of the transferred gland or in the submental space. There were no surgical complications attributed to the transfer procedure.
The SJP prevented xerostomia in 83% of the study patients. The approach appears to be oncologically sound and safe.
口干症是头颈部放疗的一种永久性且具有破坏性的后遗症，其众多后果影响着患者生活的方方面面。最近描述了一种通过塞卡利-贾 procedure（SJP）保护单个下颌下腺免受辐射损伤的新方法。
报告SJP的长期效果。
起始队列研究。患者 该试验于1999年2月1日至2002年2月1日进行。所有患者均在十字癌症研究所的头颈癌诊所接受随访。所有数据均由一名专门的研究护士收集。定期通过唾液流量研究和问卷对唾液功能进行评估。
96例患者纳入研究，38例至少随访2年。38例患者的队列分为2组：26例患者通过SJP保留了一个下颌下腺，其余12例未保留。SJP组的唾液流量得以保留，其中83%的患者在放疗后2年报告唾液量正常，而未行SJP组无一例如此。移植腺体侧或颏下间隙均无疾病复发。未发现与移植手术相关的手术并发症。
SJP使83%的研究患者预防了口干症。该方法在肿瘤学上似乎是合理且安全的。
