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腮腺切除术后涎腺囊肿的危险因素:肿瘤大小真的有影响吗?

Risk factors for sialocele after parotidectomy: Does tumor size really matter?

作者信息

Kim Bo-Soo, Kim Mi Ra, Kim Yong-Wan, Baek Moo Jin, Suh Tae-Kyung, Kim Sang-Yeon

机构信息

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea.

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Auris Nasus Larynx. 2023 Dec;50(6):935-941. doi: 10.1016/j.anl.2023.02.006. Epub 2023 Mar 14.

Abstract

OBJECTIVE

Sialocele that develops after parotid surgery often prolongs the treatment period and stresses both the surgeon and patient. The extent of surgery and tumor size are known to be associated with sialocele occurrence. We investigated the incidence of post-parotidectomy sialocele and the associated risk factors, with a focus on tumor size.

METHODS

We retrospectively reviewed the medical records of 172 patients who underwent parotidectomy between January 2013 and May 2020 at Haeundae Paik Hospital, Inje University of Korea. We stratified patients into those with and without sialocele (fluid collection in the operative bed). We compared clinical data, patient demographics, and surgical details; we identified risk factors for sialocele development after parotid surgery.

RESULTS

Seventeen patients were diagnosed with post-parotidectomy sialocele (9.88%; 17/172). Univariate logistic regression revealed that the male sex, deep lobe tumor location, and large tumor size were significantly associated with postoperative sialocele (p = 0.015, 0.009, and 0.016, respectively). We subjected these parameters to multivariate analyses; the odds ratios were 3.70, 3.58, and 2.34, respectively. Receiver operating characteristic curve analyses showed that a tumor size > 2.50 cm was the optimal cutoff in terms of predicting post-parotidectomy sialocele.

CONCLUSION

Male sex, a tumor in the deep lobe, and large tumor size were strongly associated with increased risk for sialocele after parotidectomy. Tumor size > 2.50 cm serves as the cutoff identifying patients likely to experience sialocele after parotid surgery.

摘要

目的

腮腺手术后发生的涎瘘常常会延长治疗周期,给外科医生和患者都带来压力。已知手术范围和肿瘤大小与涎瘘的发生有关。我们调查了腮腺切除术后涎瘘的发生率及相关危险因素,重点关注肿瘤大小。

方法

我们回顾性分析了2013年1月至2020年5月在韩国延世大学釜山海云台白医院接受腮腺切除术的172例患者的病历。我们将患者分为发生涎瘘(手术床积液)和未发生涎瘘两组。我们比较了临床数据、患者人口统计学资料和手术细节;确定了腮腺手术后涎瘘发生的危险因素。

结果

17例患者被诊断为腮腺切除术后涎瘘(9.88%;17/172)。单因素逻辑回归显示,男性、肿瘤位于深叶和肿瘤体积大与术后涎瘘显著相关(p分别为0.015、0.009和0.016)。我们对这些参数进行多因素分析;比值比分别为3.70、3.58和2.34。受试者工作特征曲线分析表明,肿瘤大小>2.50 cm是预测腮腺切除术后涎瘘的最佳临界值。

结论

男性患者、肿瘤位于深叶以及肿瘤体积大与腮腺切除术后涎瘘风险增加密切相关。肿瘤大小>2.50 cm可作为识别腮腺手术后可能发生涎瘘患者的临界值。

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