泪囊切除术：适应证与结果
Dacryocystectomy: indications and results.
作者信息
Matayoshi Suzana, Van Baak Alfred, Cozac Alexandra, Sardinha Mariluze, Fernandes José Byron Vicente Dias, da Mota Moura Euripedes
机构信息
Department of Ophthalmology and Otorhinolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
出版信息
Orbit. 2004 Sep;23(3):169-73. doi: 10.1080/01676830490504133.
BACKGROUND
After the advent of dacryocystorhinostomy (DCR), dacryocystectomy (DCT) was regarded as mutilant surgery and reserved for lacrimal sac tumors.
PURPOSE
To present current indications for dacryocystectomy.
METHODS
Eighteen eyes from 11 patients subjected to DCT were reviewed retrospectively. Nine patients had chronic dacryocystitis confirmed by dacryocystography and two patients had lacrimal sac tumors.
RESULTS
The indications for DCT were: three patients with systemic medical problems, three patients with dry eye, two cases of lacrimal sac tumors, two cases of traumatic dacryocystitis and one case of cutaneous leishmaniasis. Dacryocystitis was resolved in 17 of 18 eyes; the two cases of tumor evolved without epiphora. One patient (traumatic dacryocystitis) had recurrence of dacryocystitis.
CONCLUSIONS
DCT is mainly performed when a lacrimal sac tumor is suspected but, since it avoids the intra- and postoperative complications related to dacryocystorhinostomy, it can be indicated in cases of dacryocystitis with significant lacrimal discharge and an enlarged or altered lacrimal sac.
背景
泪囊鼻腔吻合术（DCR）出现后，泪囊摘除术（DCT）被视为致残性手术，仅用于泪囊肿瘤。
目的
介绍泪囊摘除术的当前适应证。
方法
回顾性分析11例接受DCT的患者的18只眼。9例经泪囊造影证实患有慢性泪囊炎，2例患有泪囊肿瘤。
结果
DCT的适应证为：3例有全身性内科问题，3例有干眼症，2例泪囊肿瘤，2例外伤性泪囊炎，1例皮肤利什曼病。18只眼中有17只眼的泪囊炎得到缓解；2例肿瘤患者病情进展但无溢泪。1例（外伤性泪囊炎）泪囊炎复发。
结论
DCT主要在怀疑有泪囊肿瘤时进行，但由于它避免了与泪囊鼻腔吻合术相关的术中及术后并发症，对于有大量泪液分泌且泪囊增大或形态改变的泪囊炎病例也可采用。
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