从单个外科医生前性数据库中对部分乳头切除术和新型乳头瘤位置分类的修改技术的结果
Jonathan W Serpell1,2, Zelia K Chiu1,2, Edward Forrest1,2
1Department of Surgery, The Alfred Hospital, Melbourne, Victoria, Australia.
ANZ journal of surgery
|October 9, 2024
概括
对良性瘤进行保守性切除术是安全有效的,而外围瘤没有增加边缘干扰或复发的风险. 常规面部神经监测确保了面部神经的低发病率.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术瘤学手术瘤学
- 头部和部手术 头部和部手术
背景情况:
- 良性瘤的保守性切除术旨在尽量减少面部神经麻,而不会影响局部复发率.
- 这项研究研究了一种经过修改的部分切除术技术,并分析了瘤位置对结果的影响.
研究的目的:
- 探索瘤位置 (表面/深叶,中心/外围) 和组织学边缘之间的关系.
- 评估瘤位置对面部神经麻和局部复发率的影响.
- 评估修改后的保守性切除术技术的安全性和有效性.
主要方法:
- 对前性收集的单个外科医生胸膜切除术数据库的分析.
- 包括瘤位置,组织学边缘,面部神经麻和局部复发数据.
- 经过修改的部分切除术,识别了面部神经和清晰的切除边缘.
主要成果:
- 在303次切除术中,84.8%是表面叶片,15.2%是深叶叶片. 大多数瘤 (81.1%) 是外围的.
- 中央和外围瘤的组织学边缘参与度类似,尽管在中央深叶瘤中更高 (P=0.003).
- 临时部分面部神经发生在6.9%的患者中;永久性发生在0.3%的患者中. 深叶瘤和全腹切除术增加了的风险 (P=0.01),而神经监测降低了它 (P<0.01). 局部复发很少发生 (2.0%的多形腺瘤).
结论:
- 保守的部分乳头切除术是安全的,适合良性乳头瘤.
- 大多数瘤是外围的,不会表现出更高的边缘参与或复发的风险.
- 常规的手术内面部神经监测对于实现较低的面部神经麻率至关重要.
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