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复发性呼吸道乳头瘤病:比较门诊和手术室治疗。

Recurrent respiratory papillomatosis: comparing in-office and operating room treatments.

机构信息

Head and Neck Department, IRCCS Policlinico San Martino, Genoa, Italy.

Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy.

出版信息

Acta Otorhinolaryngol Ital. 2024 Aug;44(4):233-241. doi: 10.14639/0392-100X-N2951.

Abstract

OBJECTIVE

We report the management of recurrent respiratory papillomatosis (RRP) employing a protocol that includes both office-based (OB) and general anaesthesia (GA) procedures. Quality of life (QoL) outcomes in the OB cohort were compared to those obtained from an historical cohort treated only under GA.

METHODS

Patients affected by RRP from 2019 until 2023 ("new protocol") and from 2012 to 2019 ("historical protocol") were enrolled. In both groups the Derkay site score (DSS) was calculated. In patients adhering to the new protocol, questionnaires measuring QoL were prospectively administered (voice handicap hindex-10 [VHI-10] along with a specific questionnaire to measure the tolerance to the OB procedures). A cost analysis was also performed.

RESULTS

In all, 35 patients composed the new protocol cohort and 13 the historical. In the first group, patients underwent a median of 4 treatments. At 2 years, 68% of patients were treated exclusively in the office. Overall, for the new protocol, median DSS and VHI-10 after one year were both significantly lower than those at baseline [2 4 and 3 14, respectively; p < 0.001]. No differences were found between the new and the historical protocol cohorts considering DSS over time.

CONCLUSIONS

Treatment of RRP may be conducted successfully in an office-based setting reducing healthcare costs.

摘要

目的

我们报告了一种包括门诊(OB)和全身麻醉(GA)程序的复发性呼吸道乳头瘤病(RRP)管理方案。比较了 OB 队列的生活质量(QoL)结果与仅在 GA 下治疗的历史队列获得的结果。

方法

招募了 2019 年至 2023 年(“新方案”)和 2012 年至 2019 年(“历史方案”)期间患有 RRP 的患者。在两组中,均计算了 Derkay 部位评分(DSS)。在遵守新方案的患者中,前瞻性地进行了 QoL 问卷调查(嗓音障碍 h 指数-10 [VHI-10] 以及专门用于测量对 OB 程序耐受性的问卷)。还进行了成本分析。

结果

共纳入 35 例新方案患者和 13 例历史患者。在第一组中,患者平均接受了 4 次治疗。2 年后,68%的患者仅在门诊接受治疗。总体而言,对于新方案,一年后中位数 DSS 和 VHI-10 均显著低于基线值[分别为 2 4 和 3 14;p <0.001]。考虑到随时间推移的 DSS,新方案和历史方案队列之间没有差异。

结论

在门诊环境中成功治疗 RRP 可以降低医疗保健成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b93d/11441516/3b24f798a23f/aoi-2024-04-233-g001.jpg

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