经腋无充气完全腔镜下颌下腺及肿瘤切除术1例

传统的颈部开放入路颌下腺切除会导致术后瘢痕,局部皮肤感觉异常或减退及皮肤粘连等问题。为解决这些问题让患者更多获益,越来越多的颈外入路内镜下颌下腺切除手术应运而生。四川省肿瘤医院头颈外科于2021年5月14日在国际上首次完成了经腋入路内镜下颌下腺切除术。患者术后康复快,美观效果满意,无并发症发生。患者术后5个月复查,颈部...     

经腋无充气腔镜与传统颈部开放手术治疗PTC的疗效分析

目的比较经腋无充气腔镜与开放术式在甲状腺乳头状癌(PTC)的疗效及术后生活质量的差异。方法回顾性分析四川省肿瘤医院头颈外科2019年5月至2021年12月采用经腋无充气腔镜手术(142例)与传统颈部开放手术(201例)治疗单侧PTC的343例患者的病例资料, 其中男性97例, 女性246例, 年龄20～69岁。对入组患者进行1∶1倾向评分匹配(PSM), 对匹配成功后的2组患者的基本特征、围手术期临床结果、术后并发症、术后生活质量(采用甲状腺癌特异性生活质量量表)、美观满意度等方面进行比较。应用SPSS 26.0软件进行统计学分析。结果 PSM后共纳入190例患者, 腔镜组和开放组各95例, 在术中失血量[20(20)ml比20(10)ml, M(IQR), 下同, Z=-2.22]、术后引流量[170(70)ml比101(55)ml, Z=-7.91]、手术时间[135(35)min比95(35)min, Z=-7.34]、住院费用[(28 188.7±2 765.1)元比(25 643.5±2 610.7)元, xˉ±s, 下同, t=0.73]、术后住院时间[(3.1±0.9)d...     

计算机辅助设计联合3D打印技术一期个体化修复重建肿瘤性下颌骨硬软组织复合式缺损2例

下颌骨肿瘤手术切除遗留的硬软复合式缺损的一期精准个体化修复一直以来是行业讨论的热点。计算机辅助设计（computer-aided design,CAD）/计算机辅助制作（computer aided-mamufacture,CAM）及 3D打印技术为此类缺损的一期修复重建提供了重要的技术保障。该技术使得修复更加精准、个体化,同时最大程度减少了骨皮瓣供区组织的损伤。本研究报道了四川省肿瘤医院收治两名口腔恶性肿瘤患者,分别采用血管化游离腓骨肌皮瓣、血管化游离骼骨肌皮瓣结合CAD/CAM及3D打印技术一期进行肿瘤切除后的硬软组织复合式缺损的一期精准个体化的修复重建,发现患者在手术治疗后取得满意的修复效果。CAD/CAM技术及3D打印技术结合游离皮瓣应用于肿瘤患者的手术可 产生良好的修复效果。     

数字化技术联合3D打印技术辅助下游离骼骨肌皮瓣修复下颌骨缺损一例

造成下颌骨病变的病因,包括口腔恶性肿瘤、下颌骨的先天性畸形、放疗后引起的骨质坏死以及头颈颌面部的外伤等。作为颞下颌关节的主要组成部分之一,下颌骨的缺陷通常会导致严重的面部畸形和咀嚼功能障碍,进而严重影响患者的生活质量。因此,个体化、精准地修复重建下颌骨的缺损成为头颈外科医生关注的重点。四川省肿瘤医院头颈外科收治1例右侧牙槽骨深面滑膜肉瘤侵犯下颌骨的青年女性患者,运用显微外科技术结合计算机辅助设计/计算机辅助制作(computer aided design/computer aided manufacture, CAD/CAM)及3D打印,采用游离骼骨肌皮瓣精准的个体化修复重建了下颌骨节段性缺损,术后达到满意的修复效果。     

敏感复发广泛期小细胞肺癌应用EP方案二线治疗的可行性，一项多中心、回顾性研究

目的：广泛期小细胞肺癌（extensive-stage small-cell lung cancer, ES-SCLC）一线治疗主要采用以化疗为基础的联合方案,进展后多推荐拓扑替康等二线化疗。对于一线使用依托泊苷联合铂类（etoposide-platin, EP）有效的人群,复发后亦可选择同方案再次治疗。但目前并无二种方案的疗效和安全性比对数据。本研究旨在探讨EP方案再治疗敏感复发ES-SCLC患者的疗效和安全性。方法：纳入153例就诊于四川省肿瘤医院等5所医疗中心并接受EP方案二线治疗的ES-SCLC患者。所有患者均接受标准一线EP方案化疗且有效。根据治疗间歇期、不同铂类方案、有无吸烟史、放疗与否等进行分组,进行回顾性分析。主要观察指标包括客观缓解率（objective response rate,ORR）、疾病控制率（disease control rate,DCR）、无进展生存时间（progression-free survival,PFS）以及药物不良反应。结果：153例患者中64例复发时间在3～6月间,89例复发时间> 6个月。86例患者一线治疗中接受过胸部放疗,有长期...     

A comparative study for the efficacies of transaxillary non-inflatable endoscopic surgery versus traditional surgery for papillary thyroid carcinoma北大核心CSCD

Objective To compare the efficacies between open surgery and axillary non‑inflatable endoscopic surgery in papillary thyroid carcinoma (PTC). Methods A retrospective analysis was performed on 343 patients with unilateral PTC treated by traditional open surgery (201 cases) and transaxillary non‑inflating endoscopic surgery (142 cases) from May 2019 to December 2021 in the Head and Neck Surgery of Sichuan Cancer Hospital. Among them, 97 were males and 246 were females, aged 20-69 years. 1∶1 propensity score matching (PSM) was performed on the enrolled patients, and the basic characteristics, perioperative clinical outcomes, postoperative complications, postoperative quality of life (Thyroid Cancer‑Specific Quality of Life), aesthetic satisfaction and other aspects of the two groups were compared after successful matching. SPSS 26.0 software was used for statistical analysis. Results A total of 190 patients were enrolled after PSM, with 95 cases in open group and 95 cases in endoscopic group. Intraoperative blood losses for endoscopic and open groups were [20 (20) ml vs. 20 (10) ml, M (IQR), Z=-2.22], postoperative drainage volumes [170 (70)ml vs. 101 (55)ml, Z=-7.91], operative time [135 (35)min vs. 95 (35)min, Z=-7.34], hospitalization cost [(28 188.7±2 765.1)yuan vs. (25 643.5±2 610.7)yuan, x̄ ± s, t=0.73], postoperative hospitalization time [(3.1±0.9)days vs. (2.6±0.9)days, t=-3.24], and drainage tube placement time [(2.5±0.8) days vs. (2.0±1.0)days, t=-4.16], with statistically significant differrences (all P<0.05). There was no significant difference in surgical complications (P>0.05). There were significant diffferences between two groups in the postoperative quality of life scores in neuromuscular, psychological, scar and cold sensation (all P<0.05), while there were no statistically significant differences in other quality of life scores (all P>0.05). In terms of aesthetic satisfaction 6 months after surgery, the endoscopic group was better than the open group, with statistically significant difference (χ2=41.47, P<0.05). Conclusion Endoscopic thyroidectomy by a gasless unilateral axillary approach is a safe and reliable surgical method, which has remarkable cosmetic effect and can improve the postoperative quality of life of patients compared with the traditional thyroidectomy. © 2023 Authors. All rights reserved.