对于残留或复发性喉瘤的内内镜手术:一种倾向性得分匹配的队列研究
Jun Fu1,2, Chunming Xu1, Zhicheng Ye1
1Jiangxi Key Laboratory of Neurological Diseases, Department of Neurosurgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Neurosurgical review
|January 26, 2026
概括
对喉瘤 (CPs) 的重复内镜内外科手术 (EES) 提供与初级EES相比的安全性,但切除率较低,复发率更高. 这种方法仍然是一个可行的选择,选择患者的复发性或残留性CP.
科学领域:
- 神经外科和内分泌学
- 瘤学和外科瘤学
- 最少侵入性的外科技术.
背景情况:
- 头骨瘤 (CPs) 在初始治疗后经常复发,需要进一步的管理.
- 内镜内外科手术 (EES) 是CP的常见方法,但其用于复发性或残留性疾病的使用仍在争论中.
- 由于复发率高,对慢性病患者的长期疾病控制仍然具有挑战性.
研究的目的:
- 评估重复的内镜内外科手术 (EES) 对复发性或残留性瘤 (CPs) 的疗效和安全性.
- 为了比较重复EES与初级EES的外科,功能和长期结果.
- 评估重复EES对复发率和患者结局的影响.
主要方法:
- 在2012年6月至2024年12月期间接受了内镜内外科手术 (EES) 的喉瘤 (CP) 患者的回顾性评估.
- 患者被划分为初级和重复EES组,并应用倾向性得分匹配 (1:2比).
- 基线特征,手术结果 (总切除 - GTR),功能结果 (视觉,内分泌),并发症和复发率的比较.
主要成果:
- 与初级EES相比,重复EES与显著较低的GTR率 (87.0%对96.7%) 和更高的复发率 (7.0%对0.0%) 相关.
- 在重复EES组中,无复发生存时间较短.
- 在重复EES组中,视力改善的频率较小 (48.5%与71.9%相比),但视力恶化,新的缺陷,并发症和内分泌结果没有显著差异.
结论:
- 针对复发性或残留性喉瘤 (CPs) 的重复内镜内外科手术 (EES) 会导致较低的总切除率 (GTR) 和复发率的增加.
- 尽管切除率有所降低,但重复EES在视觉功能,内分泌结果和术后并发症方面表现出可比的安全性.
- 重复EES是一种可行和安全的治疗选择,可用于某些患有复发性或残留性CP的患者,即使潜在的切除率较低.
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