Rajendran Balamurugan
Oral and Maxillofacial Surgeon and Oral Implantologist, RYA Cosmo Foundation, Chennai, India.
J Korean Assoc Oral Maxillofac Surg. 2020 Dec 31;46(6):373-378. doi: 10.5125/jkaoms.2020.46.6.373.
The purpose of this review is to assess the surgical outcomes of two different treatment modalities, endoscopic and open resection, for the management of sinonasal malignancies by comparing the effectiveness of these two methods. A wide search was carried out considering various electronic databases for English language articles from 2013 to 2018 using keywords such as sinonasal malignancies, endoscopic surgery, open resection for sinonasal malignancies, and endoscopic versus open surgery. One thousand articles were identified from the literature for screening. After a thorough systematic assessment and based on the selection criteria, 10 articles with 4,642 patients were included in this quantitative analysis. With a total of 4,642 patients, 1,730 patients were operated on using endoscopic resection and 2,912 patients were operated on using open resection. The endoscopic approach was found to have a shorter hospital stay compared to open surgical resection (<0.05). The rate of positive margins and the recurrence rate for open surgical resection were both smaller compared to those for endoscopic resection (>0.05), and the endoscopic approach had smaller complication rates and a higher survival rate compared to open resection (>0.05). Though endoscopic resection and open surgical resection have comparable postoperative benefits, preoperative evaluation of cases presenting with sinonasal malignancies is necessary for determining the right treatment method to obtain the best possible results postoperatively.
本综述的目的是通过比较两种方法的有效性，评估内镜手术和开放手术这两种不同治疗方式在鼻窦恶性肿瘤治疗中的手术效果。利用鼻窦恶性肿瘤、内镜手术、鼻窦恶性肿瘤的开放手术以及内镜手术与开放手术对比等关键词，在多个电子数据库中广泛检索2013年至2018年的英文文章。从文献中筛选出1000篇文章进行筛查。经过全面系统的评估并依据选择标准，本定量分析纳入了10篇文章，共涉及4642例患者。在这4642例患者中，1730例接受了内镜切除术，2912例接受了开放切除术。结果发现，与开放手术切除相比，内镜手术的住院时间更短（<0.05）。开放手术切除的切缘阳性率和复发率均低于内镜切除（>0.05），并且与开放手术相比，内镜手术的并发症发生率更低，生存率更高（>0.05）。尽管内镜切除和开放手术切除术后益处相当，但对于鼻窦恶性肿瘤患者，术前评估对于确定正确的治疗方法以获得最佳术后效果是必要的。
