Gao L, Liang Q-L, Ren W-H, Li S-M, Xue L-F, Zhi Y, Song J-Z, Wang Q-B, Dou Z-C, Yue J, Zhi K-Q
Department of Oral and Maxillofacial Surgery, Key Lab of Oral Clinical Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; Department of Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China.
Department of Head and Neck Surgery, Shaanxi Tumor Hospital, Xi'an, Shaanxi, PR China.
Br J Oral Maxillofac Surg. 2019 Dec;57(10):1003-1008. doi: 10.1016/j.bjoms.2019.08.010. Epub 2019 Aug 29.
Endoscopically-assisted partial parotidectomy for benign tumours has been reported, but we have evaluated its feasibility through different concealed incisions compared with conventional parotidectomy. A total of 124 patients with parotid tumours were enrolled in this retrospective study: an endoscopically-assisted group (n=37) compared with a group operated on conventionally (n=87). The incision for endoscopically-assisted partial, total parotidectomy and selective neck dissection was based on location and pathological characters of the parotid tumour. The sex and age of the patients, diameter of the tumour, and histopathological features were comparable between the two groups. The mean length of the incision in the endoscopic group was significantly shorter than that in the conventional group. However, intraoperative blood loss, operating time, and duration of hospital stay were significantly reduced, and postoperative secretion of saliva was significantly improved in the endoscopic group, among whom there were no recurrences of tumour. More importantly, all patients who had endoscopically-assisted operations were satisfied with the cosmetic result. Endoscopically-assisted parotidectomy is superior to conventional resection as judged by postoperative cosmetic and functional outcomes. It is noteworthy that the site of incision depends mainly on location, and on the suspected low grade of malignancy of the parotid tumour seen on preoperative computed tomography and magnetic resonance images.
内镜辅助下腮腺良性肿瘤部分切除术已有报道，但我们通过不同的隐蔽切口与传统腮腺切除术对比，评估了其可行性。本回顾性研究共纳入124例腮腺肿瘤患者：内镜辅助组（n = 37）与传统手术组（n = 87）。内镜辅助下腮腺部分切除术、全腮腺切除术及选择性颈淋巴结清扫术的切口依据腮腺肿瘤的位置和病理特征而定。两组患者的性别、年龄、肿瘤直径及组织病理学特征具有可比性。内镜组切口的平均长度显著短于传统组。然而，内镜组术中出血量、手术时间及住院时间显著减少，术后唾液分泌明显改善，且无肿瘤复发。更重要的是，所有接受内镜辅助手术的患者对美容效果均满意。从术后美容和功能结果判断，内镜辅助腮腺切除术优于传统切除术。值得注意的是，切口位置主要取决于肿瘤位置，以及术前计算机断层扫描和磁共振成像显示的腮腺肿瘤疑似低恶性程度。
