2000 年至 2006 年美国的颈部解剖术：数量、适应证和区域化。
Neck dissections in the United States from 2000 to 2006: volume, indications, and regionalization.
机构信息
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA.
出版信息
Head Neck. 2011 Jun;33(6):768-73. doi: 10.1002/hed.21536. Epub 2010 Aug 24.
BACKGROUND
The purpose of this study was to examine trends in neck dissection and regionalization.
METHODS
This cross-sectional and longitudinal study used the years 2000, 2004, and 2006 data from the Nationwide Inpatient Sample. Chi-square tests compared trends for total neck dissections and specific subsites. To test regionalization, we examined the distribution of procedures across hospital and procedure volume quartiles.
RESULTS
From 2000 to 2006, the number of neck dissections increased from 18,112 to 22,918. Three-fourths of the total increase was associated with thyroid and parathyroid gland or skin neoplasms. There was an increase in neck dissections for upper aerodigestive tract (UADT) subsites and no decline for the oropharynx and tongue base. Regionalization occurred as high-volume hospitals and providers performed a greater proportion of neck dissections over time.
CONCLUSION
Neck dissections increased from the year 2000 to 2006. There were no decreases in neck dissections for certain subsites with a greater role for primary chemoradiotherapy. Regionalization has occurred.
背景
本研究旨在探讨颈清扫术和分区化的趋势。
方法
本横断面和纵向研究使用了 2000 年、2004 年和 2006 年全国住院患者样本的数据。卡方检验比较了总颈清扫术和特定亚部位的趋势。为了检验分区化，我们检查了手术在医院和手术量四分位数中的分布。
结果
从 2000 年到 2006 年，颈清扫术的数量从 18112 例增加到 22918 例。总增加的四分之三与甲状腺和甲状旁腺或皮肤肿瘤有关。上呼吸道（UADT）亚部位的颈清扫术增加，而口咽和舌根部则没有减少。随着时间的推移，高容量医院和提供者进行了更多的颈清扫术，从而实现了分区化。
结论
从 2000 年到 2006 年，颈清扫术有所增加。对于某些亚部位，由于主要放化疗的作用更大，颈清扫术并没有减少。分区化已经发生。
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