在患有口腔腔癌的患者中,是否有选择性气管切除术的过度指示?
Diana Breda1, Sara Martins2, Ana Millán3
1Department of Maxillofacial Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra, PRT.
Cureus
|February 19, 2024
概括
在口腔癌手术中,选择性暂时气管切除术 (TT) 可能被过度使用. 某些患者,特别是那些具有特定瘤位置和阶段的患者,可能可以避免TT,减少不必要的手术.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 头部和部手术 头部和部手术
- 手术瘤学手术瘤学
背景情况:
- 在口腔瘤手术中,临时气管切除术 (TT) 经常用于确保术后的气道通透性.
- 在这种患者群体中,选择性TT的必要性和适当性需要进行调查.
研究的目的:
- 评估在接受口腔和口腔瘤手术的患者中选择性TT的过度指示率.
- 为了确定特定的患者和瘤特征,可以预测TT的避免.
主要方法:
- 对116名患有口腔和口腔支状细胞癌的患者进行了回顾性分析,这些患者接受了切除和TT.
- 应用卡梅伦和TRACHY气管切除评分系统,以追溯评估TT建议.
- 收集人口统计,并发症和并发症数据,以及瘤解剖学和重建细节.
主要成果:
- 卡梅伦和TRACHY评分系统仅在54.3%和45.7%的病例中同意TT建议,这表明潜在的过度指示.
- 瘤解剖学,重建类型,位置 (下气泡,前舌),T和N阶段 (T1/T2,N0/N1) 与更短的解时间有关.
- 通过两种评分系统确定不需要TT的患者,具有良好的瘤特征,经历了更短的脱持续时间.
结论:
- 有证据表明,在口腔和口腔癌患者中,选择性TT的过度适用性.
- 患有侧侧瘤解剖学,没有片或带有皮带片重建,前瘤位置和早期疾病 (T1/T2,N0/N1) 的患者可能是避免选择性TT的候选人.
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