以前的手术和/或放射治疗对内镜重建结果的影响
Rita Snyder1, Franco Rubino1, Scott Seaman1
1Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston , Texas , USA.
Operative neurosurgery (Hagerstown, Md.)
|August 26, 2024
概括
之前的辐射和手术不会增加内鼻外科手术后的重建并发症. 目前的重建策略,包括前置区域片,保持了底瘤管理的安全性和有效性.
科学领域:
- 神经外科 神经外科
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 头骨底部手术 头骨底部手术
背景情况:
- 对于头骨底部瘤的内外科手术需要仔细的重建.
- 之前的局部疗法 (辐射,手术) 对重建结果的影响尚不清楚.
- 评估手术前治疗史对于预防术后并发症至关重要.
研究的目的:
- 为了确定先前的辐射或手术是否会增加内鼻外科手术后重建相关并发症的风险.
- 评估当前骨基重建协议的有效性.
主要方法:
- 对418名接受内鼻瘤切除的患者 (2000-2022) 的回顾性审查.
- 根据先前的治疗史 (没有,辐射,手术) 分组的患者.
- 使用多变量回归和生存分析,分析与重建相关的发病情况 (中枢神经液泄漏,感染).
主要成果:
- 之前的治疗 (辐射/手术) 与增加的重建并发症没有显著关联.
- 使用血管化板,不吸烟史和最小的手术内泄漏是保护因素.
- 以前接受过放射治疗的患者更有可能接受道化脑周片.
结论:
- 之前的局部疗法并没有显著提高即时或延迟的重建并发症风险.
- 目前的重建管理计划,包括预先的区域板,是有效的.
- 具有重建的内外科手术在有治疗史的患者中是安全的.
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