Gawand Saurabh, Gattani Rajesh G, Aravind Kumar Chava, Pande Apoorva
General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Sep 10;16(9):e69141. doi: 10.7759/cureus.69141. eCollection 2024 Sep.
Parotid tumours, encompassing both benign and malignant forms, present significant challenges in surgical management. Traditional parotid surgery, including various forms of parotidectomy, has long been the standard approach, aiming for complete tumour removal while addressing potential complications such as facial nerve injury. However, extracapsular dissection (ECD) has emerged as an alternative technique, focusing on excising the tumour along with a thin layer of surrounding tissue, which may offer benefits in preserving healthy glandular tissue and reducing postoperative complications. This review comprehensively compares ECD and traditional parotid surgery techniques, evaluating their efficacy, outcomes, and associated complications. We analyse clinical studies and evidence to assess differences in tumour recurrence rates, facial nerve function preservation, and overall patient recovery. Additionally, the review explores the indications for each surgical approach, considering tumour characteristics and patient-specific factors. The findings suggest that while ECD may offer advantages in terms of reduced postoperative complications and improved preservation of glandular tissue, traditional parotidectomy remains a robust method for managing complex cases. This review aims to inform clinical decision-making by presenting a detailed comparison of both techniques, ultimately guiding surgeons in selecting the most appropriate approach for individual patients.
腮腺肿瘤，包括良性和恶性形式，在手术治疗中面临重大挑战。传统的腮腺手术，包括各种形式的腮腺切除术，长期以来一直是标准方法，旨在在解决诸如面神经损伤等潜在并发症的同时完全切除肿瘤。然而，包膜外剥离术（ECD）已成为一种替代技术，重点是连同薄层周围组织一起切除肿瘤，这可能在保留健康腺组织和减少术后并发症方面具有益处。本综述全面比较了ECD和传统腮腺手术技术，评估了它们的疗效、结果和相关并发症。我们分析临床研究和证据，以评估肿瘤复发率、面神经功能保留和患者总体恢复情况的差异。此外，该综述探讨了每种手术方法的适应症，同时考虑肿瘤特征和患者特定因素。研究结果表明，虽然ECD在减少术后并发症和改善腺组织保留方面可能具有优势，但传统腮腺切除术仍然是处理复杂病例的可靠方法。本综述旨在通过详细比较这两种技术为临床决策提供信息，最终指导外科医生为个体患者选择最合适的方法。
