McGurk M, Renehan A, Gleave E N, Hancock B D
Department of Oral and Maxillofacial Surgery, UMDS, Guy's Hospital, London, UK.
Br J Surg. 1996 Dec;83(12):1747-9. doi: 10.1002/bjs.1800831227.
The propensity of pleomorphic adenomas to recur is generally attributed to the biological nature of the tumour, and surgery close to the capsule is perceived as undesirable. At the Christie Hospital, Manchester, between 1947 and 1992, 475 tumours arising within the superficial portion of the parotid gland were treated by two surgical techniques: extracapsular dissection (380 patients) and superficial parotidectomy (95). Recurrence rates were 2 per cent in each group (median follow-up 12.5 years). Contact of the tumour with the facial nerve was recorded in 51 per cent of patients. There was no difference between the treatment groups in the incidence of permanent facial nerve injury (2 versus 1 per cent respectively). This study demonstrates that dissection in close proximity to the tumour is possible without inducing recurrence and that in practice the microinvasion of the capsule by tumour buds has limited clinical significance.
多形性腺瘤的复发倾向通常归因于肿瘤的生物学特性，因此人们认为在肿瘤包膜附近进行手术是不可取的。在曼彻斯特的克里斯蒂医院，1947年至1992年间，采用两种手术技术治疗了475例起源于腮腺浅叶的肿瘤：囊外剥离术（380例患者）和腮腺浅叶切除术（95例）。每组的复发率均为2%（中位随访时间12.5年）。51%的患者记录到肿瘤与面神经有接触。治疗组之间永久性面神经损伤的发生率没有差异（分别为2%和1%）。这项研究表明，在靠近肿瘤的部位进行剥离不会导致复发，而且在实际中，肿瘤芽对包膜的微侵袭临床意义有限。
