The comparative analysis of hypothermia plasma ablation and conventional resection method in endoscopic transnasal surgery for squamous-cell carcinoma in pterygopalatine fossa
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摘要: 目的:比较低温等离子消融与常规切除方式在内镜经鼻翼腭窝鳞状细胞癌手术中的疗效差异。方法:回顾性分析解放军总医院耳鼻咽喉头颈外科收治并实施鼻内镜手术的38例上颌窦鳞状细胞癌侵犯翼腭窝患者的临床资料,根据肿瘤切除方式的不同分为低温等离子组与常规手术组。比较2组平均手术时间、出血量、手术并发症、住院天数及术区愈合时间。结果:手术均相对彻底切除了上颌窦、翼腭窝肿瘤。低温等离子组与常规手术组的平均手术时间分别为(244.00±62.86)min和(294.17±73.49) min,平均术中出血量分别为(481.50±426.43)ml和(790.00±387.34)ml,平均住院天数分别为(16.75±4.45)d和(19.89±4.84)d,平均术区愈合时间分别为(8.35±1.31)周和(9.61±2.20)周,2组差异均有统计学意义(P<0.05);手术并发症发生率分别为0和11%,术后3年复发率分别为34.3%和49.4%,2组差异均无统计学意义(P>0.05)。结论:应用低温等离子刀切除病灶相对于常规手术方式具有切除效率高、术中出血少、术后恢复快等优势,其安全、微创的特点已使之成为鼻颅底手术中重要的辅助工具。Abstract: Objective: To comparative analyze the difference of effect between hypothermia plasma ablation and conventional resection method in endoscopic transnasal surgery for squamous-cell carcinoma in pterygopalatine fossa.Method: Retrospectively analyzed clinical data of 38 patients with maxillary sinus squamous-cell carcinoma invading pterygopalatine fossa admitted and treated with endoscopic surgery by department of otorhinolaryngology head and neck surgery of Chinese PLA general hospital. The patients were divided into two groups (hypothermia plasma ablation group and conventional resection group) according to different methods of resection. Compare the mean operating time, the amount of bleeding, the hospitalization days, the rate of surgery complications and the healing time between two groups.Result: Patients in both groups underwent total resection, compare the hypothermia plasma ablation group and conventional resection group, the mean operating time was(244.00±62.86)min and(294.17±73.49) min,respectively(P<0.05);the mean amount of bleeding was (481.50±426.43)ml and (790.00±387.34)ml,respectively(P<0.05);the rate of surgery complications was 0% and 11%,respectively(P>0.05); the mean hospitalization days was(16.75±4.45)d and (19.89±4.84)d,respectively(P<0.05); the mean healing time was (8.35±1.31) w and(9.61±2.20) w,respectively(P<0.05);the 3 years recurrence rate was 34.3% and 49.4%,respectively(P>0.05).Conclusion: All the patients in the study achieved relatively complete resection of tumor,the hypothermia plasma ablation has the advantage in terms of resection efficiency,the control of bleeding and the time of postoperative recovery. The feature of safe and minimally invasive has made it an important aid in skull base surgery.
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