内镜辅助下经颅耳沟切口行腮腺良性肿瘤包膜外切除术

目的探讨一种内镜辅助下经颅耳沟切除腮腺良性肿瘤的方法。 方法60例腮腺浅叶良性肿瘤患者采用随机数字表法分成内镜组及传统手术组两组。统计并比较两组患者围手术期以及术后情况，包括肿瘤的最大直径、切口的长度、手术时间、术中出血量、术后引流量及引流时间，美观满意度，术后并发症及随访情况。利用SPSS 18.0进行数据的统计分析，采用t检验和卡方检验评价两组间的差异性。 结果两组的肿瘤直径接近（t= 0.253，P= 0.234），所有的手术过程均按预期完成。内镜组平均切口长度（3.5 ± 0.4）cm小于传统手术组（9.0 ± 1.7）cm，差异有统计学意义（t= 16.645，P<0.001）。内镜组术中出血量（t= 16.028，P<0.001）、术后引流量（t= 6.499，P= 0.003）、围手术期并发症（χ²= 4.423，P= 0.035）以及外观效果（t= 16.285，P<0.001）均较传统手术组更好。术后随访10 ~ 40个月，无肿瘤复发。 结论颅耳沟切口隐蔽，内镜辅助下应用颅耳沟切口行腮腺良性肿瘤包膜外切除术适用且可靠，可以缩小手术切口并能获得满意的美观效果。

Endoscope-assisted extracapsular dissection of benign parotid tumors through a single cephaloauricular furrow incision versus a conventional approach

ObjectiveTo evaluate the feasibility of performing endoscope-assisted extracapsular dissections of benign parotid tumors using a single cephaloauricular furrow incision. MethodsSixty patients with benign parotid superficial lobe tumors were randomly divided into two groups: an endoscope-assisted (27 patients) group and conventional (33 patients) surgery group. Perioperative and post-operative outcomes of the patients were evaluated, including the maximum diameter of the tumors, length of the incision, operating time, estimated blood loss during the operation, amount and duration of drainage, satisfaction scores based on the cosmetic results, perioperative complications, and follow-up information. ResultsThe diameters of the tumors were comparable between the groups (t= 0.253, P= 0.234) , and all operations were successfully performed as planned. The mean length of the incision in the endoscope-assisted group (3.5 ± 0.4) cm was significantly shorter than the conventional group (9.0 ± 1.7) cm (t= 16.645, P<0.001) . Meanwhile, the intraoperative blood loss (t= 16.028, P<0.001) , amount of drainage (t= 6.499, P= 0.003) , perioperative complications (χ²= 4.423, P= 0.035) and cosmetic outcomes (t= 16.285, P<0.001) were all improved in the endoscope-assisted group (P<0.05) . No tumor recurrence was found during 10-40 months of follow-up. Student′s t tests and chi-squared tests were used for the comparisons between the two groups. Statistical analyses were performed using the SPSS 18.0 package, and a P-value of <0.05 was considered to indicate statistical significance. ConclusionsCephaloauricular furrow incisions were totally and naturally hidden in this procedure. Endoscope-assisted extracapsular dissections of benign parotid tumors via a small cephaloauricular furrow incision was found to be feasible and reliable, providing a minimally invasive approach and a satisfactory appearance.