3种入路切除咽旁隙良性肿瘤的疗效分析  

Efficacy analysis of three surgical approaches for the resection of benign parapharyngeal space tumors

作　　者：姚佳昕 闫贺磊 陈慧红 李果[1] 王行炜[1] 黄东海[1] 刘勇[1] YAO Jiaxin;YAN Helei;CHEN Huihong;LI Guo;WANG Xingwei;HUANG Donghai;LIU Yong(Department of Otolaryngology Head and Neck Surgery,Xiangya Hospital,Central South University,Key Laboratory of Otolaryngology for Major Diseases of Hunan Province,Hunan Clinical Research Center for Laryngopharyngeal and Voice Diseases,National Clinical Research Center for Geriatric Diseases,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院耳鼻咽喉头颈外科,耳鼻咽喉科重大疾病湖南省重点实验室,湖南省咽喉嗓音疾病临床医学研究中心,国家老年疾病临床医学研究中心,湖南长沙410008

出　　处：《中国耳鼻咽喉颅底外科杂志》2025年第1期69-75,共7页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：国家自然科学基金面上项目(82073009)。

摘　　要：目的比较传统经颈入路、内镜辅助下经颈入路及内镜辅助下经口入路3种术式切除咽旁隙良性肿瘤的疗效。方法回顾性分析2013年1月—2023年5月在中南大学湘雅医院耳鼻咽喉头颈外科收治的159例原发性咽旁隙良性肿瘤患者接受传统经颈、内镜辅助下经颈、内镜辅助下经口3种手术方式之一的临床资料。采用单因素方差分析及χ^(2)检验比较其手术情况及预后等资料。结果3种手术术中出血量(F=2.64,P=0.074)、术后引流管留置时间(F=2.44,P=0.091)、引流量(F=2.88,P=0.060)和术后出院时间(F=0.77,P=0.464)无明显差异,内镜辅助下经口入路与内镜辅助下经颈、传统经颈入路相比可缩短手术时间(F=10.70,P<0.001),且术后并发症的发生率较低(χ^(2)=9.426,P=0.009)。结论本研究3种手术入路均安全可行,能够完全切除肿瘤,并保证较低的并发症发生率。内镜辅助下经口入路相较于内镜辅助下经颈入路与传统经颈入路具有更小的创伤、更短的手术时间及更低的术后并发症发生率。但内镜操作难度较大,且有较为严格的适应证。因此,需根据症状、体征、肿瘤的性质及影像学特点等灵活选择手术方式,使患者能够最佳获益。Objective To compare the efficacy of traditional transcervical approach,endoscopy-assisted transcervical approach and endoscopy-assisted transoral approach for resection of benign parapharyngeal space tumors.Methods Clinical data of 159 patients with primary benign parapharyngeal space tumors admitted to the department of otolaryngology and head and neck surgery,xiangya hospital,central south university from January 2013 to May 2023 were retrospectively analyzed.All the patients received one of the three surgical methods:traditional transcervical,endoscopy-assisted transcervical,and endoscopy-assisted transoral.One-way ANOVA and Chi-square test were used to compare the surgical outcomes and prognosis.Results There were insignificant differences in intraoperative blood loss(F=2.64,P=0.074),retention time of postoperative drainage tube(F=2.44,P=0.091),drainage volume(F=2.88,P=0.060)and discharge time(F=0.77,P=0.464)among the three groups.Compared with endoscopy-assisted transcervical approach and traditional transcervical approach,endoscopy-assisted transoral approach had shorter operation time(F=10.70,P<0.001),and lower incidence of postoperative complications(χ^(2)=9.426,P=0.009).Conclusions The three surgical approaches used in this study are safe and feasible,capable of completely removing tumors whiles ensuring a lower incidence of complications.Compared with endoscopy-assisted transcervical and traditional transcervical approach,endoscopy-assisted transoral approach has less trauma,shorter operation time and lower incidence of postoperative complications.However,endoscopic operation is more difficult with more strict indications.Therefore,it is necessary to flexibly select the surgical approach according to the symptoms,signs,nature and imaging characteristics of the tumor,so as to achieve the best benefit for patients.

关 键 词：咽旁隙良性肿瘤 传统经颈入路 内镜辅助下经颈入路 内镜辅助下经口入路 

分 类 号：R739.63[医药卫生—肿瘤]