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临床N0患者的救助喉切除术:选择性部剖析是否适用?

Mazin Merdad¹, Nada Al Taylouni²

¹Department of Otolaryngology-Head and Neck Surgery King Abdulaziz University Jeddah Saudi Arabia.

Laryngoscope investigative otolaryngology

|April 4, 2025

概括

在临床上N0部的救援管理中,选择性部剖析 (END) 显示了中等的生存率,但并发症风险很高. 对生存益处的证据是混合的,这表明保守的方法可能对节点阴性患者更好.

科学领域:

耳鼻喉科耳鼻喉科耳鼻喉科
手术瘤学手术瘤学
头部和部癌症管理管理

背景情况:

在救援喉腔切除术中,临床上阴性节点 (N0) 的部需要谨慎管理.
在这些情况下,选择性部解剖 (END) 的作用是有争议的.
了解隐性转移和并发症率至关重要.

研究的目的:

系统地审查和元分析END在临床N0子的救援治疗中的有效性.
评估隐藏的结节转移,生存结果和与END相关的术后并发症.

主要方法:

在PubMed/Medline,谷歌学者和科克兰图书馆进行系统搜索.
包括8项分析隐性转移,存活率和N0患者的并发症的研究,这些患者接受了带END的救援喉切除术.
固定和随机效应模型的应用,用于聚合估计和异质性评估,使用tau2,I2和Cochran的Q测试.

主要成果:

放射治疗后临床N0部的隐性转移率在4%到10%之间.
总体存活率约为52%,不清楚的存活优势来自END.
在END中观察到高并发症率 (高达47.4%),而转移检测率为10% -13%.

结论:

目前的证据并不一致支持在N0个救援案例中END的生存益处.
与END相关的显著发病率引起了人们对日常使用的担忧.
由于高并发症风险,对N0患者可能更喜欢保守的方法;需要进一步的前性研究.

关键词:

选择性的子部课程喉切除术是指进行喉切除术.部解剖部解剖部解剖隐秘的节点节点.

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