腮腺癌不规范手术后的特点及再手术治疗

Characteristics of parotid gland cancer after nonstandard surgical treatment and its reoperation

目的总结腮腺癌不规范手术后的特点,探讨腮腺癌不规范手术后再手术的适应证及手术方式。方法总结1 998年6月～201 0年6月在外院行腮腺癌切除术后又至我院再次手术的52例腮腺癌患者的完整临床资料,分析手术情况并对临床资料进行统计。结果病理检查证实再手术患者肿瘤残留率为82.7%(43/52),面神经完好保存率为82.7%(43/52),面神经分支损伤率为1.9%(1/52),面神经部分切除率为7.7%(4/52),面神经全切除率为7.7%(4/52);增强CT扫描的灵敏度为86.7%(39/45),阳性预测值为90.7%(39/43)。结论腮腺癌不规范手术后的肿瘤残留率较高,慎重的再手术很有必要。增强CT扫描检查对于发现肿瘤残留有较高的阳性预测值,对于筛选再手术患者有重要意义。

OBJECTIVE To evaluate the characteristics of parotid gland cancer after nonstandard surgical treatment and the value of reoperation. METHODS The data of 52 cases suffered parotid gland cancer who received nonstandard operation at other hospital and received reoperation in our hospital from June 1998 to June 2010 were respectively reviewed. RESULTS Among all cases,parotid gland cancer was residual in 43 cases,the facial nerve preservation rate was 82.7%（43/52）,the facial nerve branches injury rate was 1.9%（1/52）,the facial nerve partial resection rate was 7.7%（4/52） and the total resection rate was 7.7%（4/52）.The sensitivity of contrast-enhanced CT in scanning residual turmor was 86.7%and the CT positive predictive value was 90.7%.CONCLUSION In consideration of the higher residual tumor rate in patients who received nonstandard operations,the reoperations were necessary.The positive predictive value of contrast- enhanced CT was high in detecting the residual tumor,which was important in screening patients for reoperation.