Jia Z Y, Zhang X Y, Jiang C B, Zhao Y Z, Zhang R, Fan X H, Zhang Y H
Department of Oral and Maxillofacial Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
Respiratory Sleep Division, the Third Hospital of Hebei Medical University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Jun 5;31(11):863-869. doi: 10.13201/j.issn.1001-1781.2017.11.011.
The aim of this study is to systematically assess the clinical outcomes of extracapsular dissection (ECD) and superficial parotidectomy (SP), and to provide evidences for the clinical decision for treatment of parotid gland benign tumors. Relevant studies that compared the outcomes of extracapsular dissection and superficial parotidectomy for the parotid benign tumors were searched in Pubmed, CNKI and Wangfang data databases, and Meta-analysis was performed using software RevMan 5.0. Fifteen studies were selected for the Meta-analysis. A total of 2 929 participants were included in those studies, of which 1 796 underwent ECD and 1 133 underwent SP. The recurrence rates for ECD and SP were 1.29% (23 of 1 776 cases) and 1.48% (16 of 1 081 cases), respectively. There were no statistically significant in recurrence rate between ECD and SP. The rates of transient facial nerve paresis for ECD and SP were 5.48% (74 of 1 350) and 22.94% (139 of 606), that of permanent facial nerve paralysis were 0.66% (8 of 1 221) and 2.71% (15 of 554). The incidences of Frey's syndrome in ECD group and SP group were 1.91% (26 of 1 360) and 16.71% (111 of 664), that of fistula in were 0.53% (5 of 946) and 2.96% (10 of 338). ECD could reduce the risk for complications compared with SP. This systematic review with Meta-analysis suggests that ECD has a similar recurrence rate as SP with fewer postoperative complications. ECD may be considered as an alternative surgical modality for select benign parotid tumor.
本研究旨在系统评估腮腺浅叶切除术(SP)和包膜外剥离术(ECD)的临床疗效,为腮腺良性肿瘤的临床治疗决策提供依据。通过检索PubMed、中国知网和万方数据库,查找比较ECD和SP治疗腮腺良性肿瘤疗效的相关研究,并采用RevMan 5.0软件进行Meta分析。共纳入15项研究进行Meta分析,这些研究共纳入2929例参与者,其中1796例行ECD,1133例行SP。ECD组和SP组的复发率分别为1.29%(1776例中的23例)和1.48%(1081例中的16例),两组复发率差异无统计学意义。ECD组和SP组的暂时性面神经麻痹发生率分别为5.48%(1350例中的74例)和22.94%(606例中的139例),永久性面神经麻痹发生率分别为0.66%(1221例中的8例)和2.71%(554例中的15例)。ECD组和SP组的味觉出汗综合征发生率分别为1.91%(1360例中的26例)和16.71%(664例中的111例),涎瘘发生率分别为0.53%(946例中的5例)和2.96%(338例中的10例)。与SP相比,ECD可降低并发症风险。这项Meta分析系统评价表明,ECD与SP的复发率相似,但术后并发症较少。对于某些良性腮腺肿瘤,ECD可作为一种替代手术方式。