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腮腺良性肿瘤治疗中的部分浅叶、浅叶及全腮腺切除术:205例患者的10年前瞻性研究

Partial Superficial, Superficial, and Total Parotidectomy in the Management of Benign Parotid Gland Tumors: A 10-Year Prospective Study of 205 Patients.

作者信息

Stathopoulos Panagiotis, Igoumenakis Dimosthenis, Smith William P

机构信息

Associate Professor, Dublin Dental University Hospital, Dublin; Consultant Oral and Maxillofacial Surgeon, St James and Mater Hospitals, Dublin, Ireland.

Oral and Maxillofacial Surgeon, Biostatistics, Heraklion General Hospital, Heraklion, Greece.

出版信息

J Oral Maxillofac Surg. 2018 Feb;76(2):455-459. doi: 10.1016/j.joms.2017.06.018. Epub 2017 Jun 23.

Abstract

PURPOSE

The aim of this report is to present an overview of the authors' experience in treating parotid gland tumors for a period of 10 years. This report describes patients' demographics, surgical outcomes, and complications and discusses the management of benign disease with particular emphasis on the importance of facial nerve dissection.

PATIENTS AND METHODS

A total of 205 consecutive patients with different parotid gland tumors underwent surgery at Northampton General Hospital (Northampton, UK) from October 2000 to November 2010. Data were prospectively collected and entered into an electronic database. Patients' demographics, clinical tumor size, type of operation, fine-needle aspiration result, facial nerve status, final histopathologic report, and intraoperative and postoperative complications were recorded and analyzed.

RESULTS

This study confirmed that good results in low recurrence rate and minimal risk of facial nerve weakness can be achieved with operations less aggressive than traditional superficial parotidectomy, such as partial superficial parotidectomy. Transient facial nerve palsy was significantly more frequent after total (40%; P < .001) and superficial (28%; P < .05) parotidectomy, respectively, than after partial superficial parotidectomy (9.6%).

CONCLUSION

Because the risk or recurrence is higher when surgery is performed by inexperienced surgeons, the authors advocate that parotid gland surgery should be performed by adequately trained operators and the surgical specimen ideally should be examined by a histopathologist experienced in the diagnosis of salivary gland tumors. Recurrence rate for these tumors increases with time; therefore, long-term follow-up is required for these patients.

摘要

目的

本报告旨在概述作者10年来治疗腮腺肿瘤的经验。本报告描述了患者的人口统计学特征、手术结果和并发症,并讨论了良性疾病的治疗方法,特别强调面神经解剖的重要性。

患者与方法

2000年10月至2010年11月期间,共有205例连续的不同腮腺肿瘤患者在英国北安普敦综合医院接受了手术。前瞻性收集数据并录入电子数据库。记录并分析患者的人口统计学特征、临床肿瘤大小、手术类型、细针穿刺结果、面神经状况、最终组织病理学报告以及术中及术后并发症。

结果

本研究证实,与传统的腮腺浅叶切除术相比,采用侵袭性较小的手术,如部分腮腺浅叶切除术,可获得低复发率和低面神经麻痹风险的良好效果。全腮腺切除术(40%;P < 0.001)和腮腺浅叶切除术(28%;P < 0.05)后,短暂性面神经麻痹的发生率分别显著高于部分腮腺浅叶切除术(9.6%)。

结论

由于经验不足的外科医生进行手术时复发风险较高,作者主张腮腺手术应由训练有素的操作人员进行,手术标本理想情况下应由在唾液腺肿瘤诊断方面经验丰富的组织病理学家进行检查。这些肿瘤的复发率随时间增加;因此,这些患者需要长期随访。

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