Vogel Todd R, Mousa Albeir Y, Dombrovskiy Viktor Y, Haser Paul B, Graham Alan M
Division of Vascular Surgery, The Surgical Outcomes Research Group, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Vasc Endovascular Surg. 2009 Oct-Nov;43(5):457-61. doi: 10.1177/1538574409335274. Epub 2009 Jul 29.
To evaluate the impact of carotid reconstruction (REC) and pre-operative embolization (EMB) for Carotid Body Tumor (CBT) surgery.
Retrospective study utilizing the Nationwide Inpatient Sample (2002-2006).
2117 patients (mean age 56.5 +/- 17.2 years) underwent CBT surgery: 1686 excision alone (EX); 129 excision with embolization (EX+EMB); and 302 excision with carotid artery reconstruction (EX+REC). EX+REC compared to EX had greater rates of mortality (1.61%vs.0.59%; P =.0495), stroke (17.7% vs. 3.5%; P < .0002), and postoperative hemorrhage (43.1% vs. 2.4%; P < 0.002). EX+EMB did not demonstrate increased mortality or stroke compared to EX and the rate of postoperative hematoma was similar between groups (P = .3144).
CBT resection is a relatively rare procedure and when combined with EMB was more expensive, but was associated with significantly fewer complications and decreased blood product utilization. These data suggest that CBT surgery requiring carotid reconstruction carries significant morbidity and that EMB as an adjunctive tool was beneficial for CBT surgery outcomes.
评估颈动脉重建术（REC）和术前栓塞术（EMB）对颈动脉体瘤（CBT）手术的影响。
利用全国住院患者样本（2002 - 2006年）进行回顾性研究。
2117例患者（平均年龄56.5±17.2岁）接受了CBT手术：1686例单纯切除术（EX）；129例切除加栓塞术（EX + EMB）；302例切除加颈动脉重建术（EX + REC）。与EX相比，EX + REC的死亡率（1.61%对0.59%；P = 0.0495）、中风发生率（17.7%对3.5%；P < 0.0002）和术后出血率（43.1%对2.4%；P < 0.002）更高。与EX相比，EX + EMB未显示死亡率或中风增加，且两组术后血肿发生率相似（P = 0.3144）。
CBT切除术是一种相对少见的手术，与EMB联合使用时费用更高，但并发症明显更少且血液制品使用减少。这些数据表明，需要颈动脉重建的CBT手术具有较高的发病率，而EMB作为辅助工具对CBT手术结果有益。
