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包膜外解剖与部分腮腺浅叶切除术治疗腮腺良性肿瘤。

Extracapsular dissection versus partial superficial parotidectomy for the treatment of benign parotid tumours.

机构信息

Department of Maxillofacial Surgery, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.

The Central Laboratory of The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.

出版信息

Int J Oral Maxillofac Surg. 2019 Jul;48(7):895-901. doi: 10.1016/j.ijom.2019.01.030. Epub 2019 Mar 11.

Abstract

The purpose of this study was to compare the complications of patients treated for a benign parotid tumour (BPT) by extracapsular dissection (ECD) vs. partial superficial parotidectomy (PSP). A comprehensive literature investigation was conducted by searching electronic databases. A systematic review and meta-analysis of comparative studies were performed to assess ECD and PSP for the treatment of BPTs with fixed-effects models. The outcomes analysed were transient or permanent facial nerve injury, Frey syndrome, recurrence rate, infection, and salivary fistula/sialocele. A total of 1641 patients from seven studies (1120 ECD-treated and 521 PSP-treated patients) were included in this meta-analysis. Transient facial nerve injury (odds ratio (OR)=0.28, 95% confidence interval (CI): 0.11-0.71; p=0.008) and Frey syndrome (OR=0.12, 95% CI: 0.03-0.48; p=0.003) were less prevalent in the ECD group. The rates of permanent facial nerve injury (OR=0.77, 95% CI: 0.35-1.70; p=0.520), recurrence rate (OR=0.17, 95% CI: 0.02-1.75; p=0.14), infection (OR=0.70, 95% CI: 0.07-6.67; p=0.76), and salivary fistula/sialocele (OR=0.40, 95% CI: 0.06-2.66; p=0.350) were similar in both groups. Although there was a trend that ECD showed a reduced risk for complications, the present results are not sufficient to conclude that ECD is more beneficial than PSP.

摘要

本研究旨在比较囊外解剖(ECD)与部分腮腺浅叶切除术(PSP)治疗腮腺良性肿瘤(BPT)患者的并发症。通过检索电子数据库进行了全面的文献调查。采用固定效应模型对 ECD 和 PSP 治疗 BPT 的比较研究进行了系统评价和荟萃分析。分析的结果是暂时或永久性面神经损伤、Frey 综合征、复发率、感染和涎瘘/涎肿。这项荟萃分析共纳入了 7 项研究的 1641 例患者(1120 例 ECD 治疗和 521 例 PSP 治疗)。ECD 组暂时性面神经损伤(比值比(OR)=0.28,95%置信区间(CI):0.11-0.71;p=0.008)和 Frey 综合征(OR=0.12,95%CI:0.03-0.48;p=0.003)的发生率较低。ECD 组永久性面神经损伤的发生率(OR=0.77,95%CI:0.35-1.70;p=0.520)、复发率(OR=0.17,95%CI:0.02-1.75;p=0.14)、感染率(OR=0.70,95%CI:0.07-6.67;p=0.76)和涎瘘/涎肿(OR=0.40,95%CI:0.06-2.66;p=0.350)与 PSP 组相似。尽管 ECD 有降低并发症风险的趋势,但目前的结果还不足以得出 ECD 比 PSP 更有益的结论。

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