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目的通过与传统手术临床对照研究,评估颈部小切口电视内镜颌下腺切除术的可行性及其优点。方法术前评估为良性肿瘤的病例26例,手术于颈部皮纹内长2.0~2.5 cm的小切口下,内镜辅助完成颌下腺切除术。与同期进行的传统手术病例65例,进行对照研究。对两组病例切口长度、手术时间、术中出血量进行统计分析,比较有无统计学差异。结果两组91例手术完成顺利,内镜组切口(2.3±0.2)cm;术中出血(9.4±4.2)mL;手术时间(74±12)min;术后总引流量平均(21.2±5.7)mL。1例术后出现同侧舌部麻木,2周后恢复。无面神经及舌下神经损伤病例。与传统手术比较,手术切口缩短(P<0.01),出血减少(P<0.01),术后引流量减少(P<0.05),差异有统计学意义。而手术时间差别无统计学意义(P>0.05)。全部病例随访1~5年,平均29个月,均未见复发。结论内镜下颈部小切口颌下腺切除术手术切口明显缩小,术后美观效果好,并发症少,是一种较为理想的颌下腺切除方法。
Objective To evaluate the feasibility and advantages of endoscopic submandibular gland resection with small incision in neck through clinical control study with traditional surgery. Methods Twenty - six patients with benign tumors were evaluated preoperatively. Under the small incision of 2.0 ~ 2.5 cm in the internal dermal stripes of the neck, endoscopic assisted submandibular gland resection was performed. With the same period in the traditional surgical cases of 65 cases, a controlled study. The incision length, operation time and intraoperative blood loss of two groups of patients were statistically analyzed, with or without statistical difference. Results The operation of 91 cases in both groups was completed successfully. The endoscopic incision (2.3 ± 0.2) cm, intraoperative bleeding (9.4 ± 4.2) mL, operation time (74 ± 12) min and postoperative total drainage (21.2 ± 5.7) mL. One case had ipsilateral tongue numbing and recovered after 2 weeks. No facial nerve and hypoglossal nerve injury cases. Compared with the traditional operation, the surgical incision was shortened (P <0.01), the bleeding was reduced (P <0.01), and the drainage was decreased after operation (P <0.05). The difference was statistically significant. The operation time difference was not statistically significant (P> 0.05). All cases were followed up 1 to 5 years, an average of 29 months, no recurrence. Conclusions The endoscopic incision for submandibular gland dissection with small incision in the neck is significantly reduced. The postoperative aesthetic effect is good and there are few complications. It is an ideal submandibular gland resection method.