Zhu Xiaoke, Shi Xiaoling, Zhou Liang, Zhang Ming, Cheng Lei, Shi Yong, Xu Chengzhi, Wu Chunping, Liu Quan, Cao Pengyu, Tao Lei
Department of Otolaryngology, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, PR China.
Department of Otolaryngology, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, PR China.
Eur J Surg Oncol. 2023 Jan;49(1):47-54. doi: 10.1016/j.ejso.2022.08.016. Epub 2022 Aug 18.
Surgery remains the mainstay treatment for parapharyngeal space (PPS) tumors. Given the rapid advance and increasing usage of endoscopic and robotic techniques, we aimed to investigate the surgical trends of PPS tumors in our institution and analyze their impact on patients' treatment outcomes.
All patients who underwent surgical resection of PPS tumors from 2014 to 2021 at the Eye, Ear, Nose, and Throat Hospital of Fudan University were retrospectively reviewed. Student's t-test, Chi-square test, and multinomial logistic regression analyses were used to compare the surgical outcomes between groups.
Of the included 389 patients, the recipients of endoscopic surgery have largely increased in our center, with 17 of 134 cases (12.7%) in the group 2014-2017 and 187 of 255 cases (73.3%) in the group 2018-2021. The use of transoral and trans-nasal approaches increased in recent years (5.2% in 2014-2017 vs. 26.0% in 2018-2021), while that of trans-mandibular and lateral skull base approaches decreased (5.9% in 2014-2017 vs. 0.8% in 2018-2021). Decreased blood loss of operation and decreased risks of postoperative neurovascular complications were observed in the group 2018-2021. Similar findings were observed among patients receiving endoscopic surgery when compared with those receiving conventional surgery.
In our institution, the overall trends in the surgical management of PPS tumors moved towards minimally invasive approaches with the assistance of endoscopy or surgical robots. The two surgical techniques were feasible and safe, and to a great extent, contributed to the improved surgical outcomes we observed in recent years.
手术仍然是咽旁间隙（PPS）肿瘤的主要治疗方法。鉴于内镜和机器人技术的迅速发展及应用日益广泛，我们旨在研究我院PPS肿瘤的手术趋势，并分析其对患者治疗结果的影响。
对2014年至2021年在复旦大学附属眼耳鼻喉科医院接受PPS肿瘤手术切除的所有患者进行回顾性研究。采用学生t检验、卡方检验和多项逻辑回归分析比较各组间的手术结果。
在纳入的389例患者中，我院内镜手术的接受者大幅增加，2014 - 2017年组134例中有17例（12.7%），2018 - 2021年组255例中有187例（73.3%）。近年来经口和经鼻入路的使用增加（2014 - 2017年为5.2%，2018 - 2021年为26.0%），而经下颌和侧颅底入路的使用减少（2014 - 2017年为5.9%，2018 - 2021年为0.8%）。2018 - 2021年组手术失血减少，术后神经血管并发症风险降低。与接受传统手术的患者相比，接受内镜手术的患者也有类似发现。
在我院，PPS肿瘤手术治疗的总体趋势是在内镜或手术机器人辅助下朝着微创方法发展。这两种手术技术可行且安全，在很大程度上促成了我们近年来观察到的手术结果改善。
