外科治疗内翻性乳头状瘤；247 例长期随访的单中心分析。
Surgical management of inverted papilloma; a single-center analysis of 247 patients with long follow-up.
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, 's-Gravendijkwal 230, 3015 CE,, Rotterdam, The Netherlands.
出版信息
J Otolaryngol Head Neck Surg. 2017 Dec 20;46(1):67. doi: 10.1186/s40463-017-0246-7.
Abstract
BACKGROUND
Our aim was to review our management of inverted papilloma (IP), perform a recurrence analysis, and review the literature.
METHODS
A retrospective analysis of 247 patients treated for an IP. Patients were grouped according to surgical approach, tumor presentation (primary, residual and recurrence) and Krouse-stage.
RESULTS
Recurrence was observed in 20.3%, 28.6% and 35.1% (p = 0.017) of the patients who underwent endoscopic, external and combined surgery, respectively. Recurrences occurred more often in residual than primary IP (36.9% vs. 22.3%, p = 0.021). Primary endoscopic surgery had a recurrence rate of 12.5%, which was comparable to the recent literature (11.2%, 161/1433).
CONCLUSIONS
The relatively high number of recurrences in this cohort is explained by the long follow-up and previous (incomplete) surgery in 61.5% of the cases. The inferior outcome of residual IP underscores the importance of having a low threshold for preoperative biopsy in unilateral and atypical sinonasal disease.
摘要
背景
我们旨在回顾我们对内翻性乳头状瘤（IP）的治疗方法，进行复发分析，并复习文献。
方法
对 247 例接受 IP 治疗的患者进行回顾性分析。根据手术方式、肿瘤表现（原发性、残留和复发）和 Krouse 分期对患者进行分组。
结果
分别接受内镜、外科学和联合手术的患者中，复发率分别为 20.3%、28.6%和 35.1%（p=0.017）。残留 IP 的复发率（36.9%）高于原发性 IP（22.3%）（p=0.021）。原发性内镜手术的复发率为 12.5%，与近期文献报道（11.2%，161/1433）相当。
结论
本队列中较高的复发率是由于 61.5%的病例存在长期随访和先前（不完全）手术。残留 IP 的不良结局突出了在单侧和非典型鼻-鼻窦疾病中术前活检门槛较低的重要性。
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