腮腺良性肿瘤包膜外切除术的循证医学分析

贾志宇; 张晓英; 蒋崇槟; 赵云转; 张睿; 范戌辉; 张英怀

doi:10.13201/j.issn.1001-1781.2017.11.011

腮腺良性肿瘤包膜外切除术的循证医学分析

- 1 河北医科大学第二医院口腔颌面外科(石家庄, 050000);
- 2 河北医科大学第三医院呼吸睡眠科

详细信息

通讯作者: 张英怀,E-mail:zhyh787@163.com

中图分类号: R739.87

收稿日期: 2017-01-04

Extracapsular dissection versus superficial parotidectomy for treatment of parotid benign tumors:evidence based medicine analysis

- 1 Department of Oral and Maxillofacial Surgery, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China;
- 2 Respiratory sleep division, the Third Hospital of Hebei Medical University

More Information

Corresponding author: ZHANG Yinghuai, E-mail: zhyh787@163.com

Received Date: 04 January 2017

摘要

摘要: 目的: 比较腮腺包膜外切除术(ECD)和腮腺切叶切除术(SP)术后复发和并发症的发生率,为临床治疗腮腺良性肿瘤选择合适的手术方式提供理论依据。方法: 在Pubmed、中国期刊全文数据库(CNKI)和万方数据库检索比较SP和ECD手术方法转归的相关文献,采用RevMan 5.0软件进行Meta分析。结果: 获得15篇文献用于Meta分析,共包括2 929例患者,其中1 796例接受ECD,1 133例接受SP。ECD和SP的术后复发率分别为1.29%(23 /1 776) 和1.48%(16/ 1 081),差异无统计学意义。ECD与SP术后暂时性面瘫的发生率分别为5.48%(74/1 350)和22.94%(139/606),永久性面瘫的发生率分别为0.66%(8/1 221)和2.71%(15/554),Frey综合征的发生率分别为1.91%(26/1 360)和16.71%(111/664),涎瘘的发生率分别为0.53%(5/946)和2.96%(10/338),与SP相比,ECD术后并发症的发生率明显降低。结论: 与SP相比,ECD并发症发生率低,而肿瘤的复发率并没有增高,提示在适应证选择正确的情况下,ECD可以取代SP用于腮腺良性肿瘤的治疗。
- 腮腺肿瘤 /
- 腮腺包膜外切除术 /
- 腮腺浅叶切除术 /
- Meta分析
Abstract: Objective: The aim of this study is to systematically assess the clinical outcomes of extracapsular dissection(ECD) and Superficial parotidectomy(SP), and to provide evidences for the clinical decision for treatment of parotid gland benign tumors.Method: Relevant studies that compared the outcomes of extracapsular dissection and superficial parotidectomy for the parotid benign tumors were searched in Pubmed, CNKI and Wangfang data databases, and Meta-analysis was performed using software RevMan 5.0.Result: Fifteen studies were selected for the Meta-analysis. A total of 2 929 participants were included in those studies, of which 1 796 underwent ECD and 1 133 underwent SP. The recurrence rates for ECD and SP were 1.29%(23 of 1 776 cases) and 1.48%(16 of 1 081 cases), respectively. There were no statistically significant in recurrence rate between ECD and SP. The rates of transient facial nerve paresis for ECD and SP were 5.48%(74 of 1 350) and 22.94%(139 of 606), that of permanent facial nerve paralysis were 0.66%(8 of 1 221)and 2.71%(15 of 554).The incidences of Frey's syndrome in ECD group and SP group were 1.91%(26 of 1 360) and 16.71%(111 of 664), that of fistula in were 0.53%(5 of 946) and 2.96%(10 of 338). ECD could reduce the risk for complications compared with SP.Conclusion: This systematic review with Meta-analysis suggests that ECD has a similar recurrence rate as SP with fewer postoperative complications. ECD may be considered as an alternative surgical modality for select benign parotid tumor.
- parotid neoplasms /
- extracapsular dissection /
- superficial parotidectomy /
- Meta-analysis

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参考文献(33)

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