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相关并发症的比较:前哨淋巴结活检与选择性颈部清扫术

Comparison of related complications: sentinel node biopsy versus elective neck dissection.

作者信息

Hernando J, Villarreal P, Alvarez-Marcos F, Gallego L, García-Consuegra L, Junquera L

机构信息

Department of Oral and Maxillofacial Surgery, Donostia University Hospital, San Sebastián, Spain.

Oral and Maxillofacial Surgeon, Private Practice, Oviedo, Spain.

出版信息

Int J Oral Maxillofac Surg. 2014 Nov;43(11):1307-12. doi: 10.1016/j.ijom.2014.07.016. Epub 2014 Aug 12.

Abstract

Sentinel node biopsy (SNB) is considered a feasible neck staging tool in early oral squamous cell carcinoma. The aim of this study was to compare postoperative morbidity in patients who had undergone SNB and elective neck dissection (END). Seventy-three consecutive patients were included between the years 2005 and 2009. The patients were divided into two groups according to neck management: SNB and END groups. Kaplan-Meier survival analysis was used to compare disease-free survival (DFS) and overall survival (OS) between the groups. Shoulder function, length of the surgical scar, and the degree of cervical lymphoedema were assessed. Neck haematoma and the presence of oro-cervical communication were also analyzed. Thirty-two patients underwent SNB and 41 underwent an END (levels I-III). Seven regional recurrences were recorded in the END group. Three neck recurrences occurred in the SNB group. No significant differences were found in DFS or OS between the groups. There were statistically significant differences between the groups in shoulder function and average scar length. However, differences in degree of lymphoedema were not statistically significant. Neck hematomas and oro-cervical communications occurred only in the END group. From this study, it can be concluded that SNB presents less postoperative morbidity than END.

摘要

前哨淋巴结活检(SNB)被认为是早期口腔鳞状细胞癌可行的颈部分期工具。本研究的目的是比较接受SNB和选择性颈清扫术(END)患者的术后发病率。2005年至2009年期间连续纳入73例患者。根据颈部处理方式将患者分为两组:SNB组和END组。采用Kaplan-Meier生存分析比较两组之间的无病生存期(DFS)和总生存期(OS)。评估肩部功能、手术瘢痕长度和颈部淋巴水肿程度。还分析了颈部血肿和口颈贯通情况。32例患者接受了SNB,41例接受了END(I-III区)。END组记录到7例区域复发。SNB组发生3例颈部复发。两组之间在DFS或OS方面未发现显著差异。两组在肩部功能和平均瘢痕长度方面存在统计学显著差异。然而,淋巴水肿程度的差异无统计学意义。颈部血肿和口颈贯通仅发生在END组。从本研究可以得出结论,SNB的术后发病率低于END。

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