Zhang Dong-Kun, Guo Zhu-Ming, Zhang Quan, Zeng Zong-Yuan, Chen Fu-Jin, Chen Wen-Kuan, Li Hao, Wang Shun-Lan
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, PR China.
Ai Zheng. 2008 Jan;27(1):105-8.
BACKGROUND & OBJECTIVE: Dissecting the facial nerves safely is an important guarantee for the accomplishment of parotidectomy and reduction of postoperative complications. This study was to explore the application of helix water jet to parotidectomy.
Clinical data of 43 patients with parotid tumors, who received operation with helix water jet from Feb. 2004 to Feb. 2005 at Cancer Center of Sun Yat-Sen University, were analyzed. Meanwhile, traditional techniques in parotidectomy was performed in 36 patients (control group). Duration of operation, postoperative drainage volume, postoperative hospitalization, and occurrence of postoperative complications, such as facial nerve dysfunction and salivary fistula, of the 2 groups were compared.
The postoperative drainage volume was significantly lower in water jet group than in control group [(9.89+/-3.74) mL vs. (12.15+/-2.11) mL, P<0.05]. There were no significant differences in duration of operation [(90.28+/-25.30) min vs. (76.32+/-20.74) min, P>0.05], postoperative hospitalization [(6.39+/-1.38) days vs. (6.45+/-1.05) days, P>0.05] between the two groups. Of the 43 patients in water jet group, 6 (14.0%) had grade II facial nerve dysfunction and 1 (2.3%) had grade III facial nerve dysfunction; of the 36 patients in control group, 5 (13.9%) had grade II facial nerve dysfunction, 2 (5.6%) had grade III facial nerve dysfunction, 1 (2.8%) had grade IV facial nerve dysfunction and 1 (2.8%) had salivary fistula. There was no permanent facial nerve dysfunction occurred in both groups. There was no significant difference in the occurrence of complications between the two groups. Nine patients who retained nervus auricularis magnus suffered from slight numbness symptom of auricular lobule.
Use of helix water jet in parotid surgery is safe and confers some advantages over conventional methods of parotid dissection.
安全解剖面神经是完成腮腺切除术及减少术后并发症的重要保证。本研究旨在探讨螺旋水刀在腮腺切除术中的应用。
分析2004年2月至2005年2月在中山大学肿瘤防治中心接受螺旋水刀手术的43例腮腺肿瘤患者的临床资料。同时，对36例患者采用传统腮腺切除技术（对照组）。比较两组的手术时间、术后引流量、术后住院时间及术后并发症（如面神经功能障碍和涎瘘）的发生情况。
水刀组术后引流量明显低于对照组[（9.89±3.74）ml对（12.15±2.11）ml，P<0.05]。两组手术时间[（90.28±25.30）分钟对（76.32±20.74）分钟，P>0.05]、术后住院时间[（6.39±1.38）天对（6.45±1.05）天，P>0.05]差异无统计学意义。水刀组43例患者中，6例（14.0%）出现Ⅱ级面神经功能障碍，1例（2.3%）出现Ⅲ级面神经功能障碍；对照组36例患者中，5例（13.9%）出现Ⅱ级面神经功能障碍，2例（5.6%）出现Ⅲ级面神经功能障碍，1例（2.8%）出现Ⅳ级面神经功能障碍，1例（2.8%）出现涎瘘。两组均未发生永久性面神经功能障碍。两组并发症发生率差异无统计学意义。9例保留耳大神经的患者出现耳垂轻度麻木症状。
螺旋水刀应用于腮腺手术是安全的，与传统腮腺解剖方法相比具有一定优势。
