颈部内镜颌下腺切除术和传统手术的对照研究

Comparison of endoscopic resection and a conventional method for submandibular gland

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．O～2．5cm的小切13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倒手术完成顺利，内镜组切1：2（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 investigate the feasibility and advantage of endoscopic resection of submandibular gland through a minimal incision. Methods Twenty-six patients, diagnosed as benign diseases of submandibular gland from 2006 to 2012, were treated with endoscopic resection of submandibular gland through a 2.0-2.5 cm skin incision. The incision length, intraoperative bleeding, operation duration drainage of the wound and complication were reviewed and compared with the control group in which 65 patients received conventional surgical resection. Results Surgery in all the 91 patients were successfully performed without relapse during the follow-up （ 1 to 5 years）. Of the endoscopic group,the incision length, total intraoperative bleeding , operation duration and drainage of the wound were 2.3 ± 0.2 cm, 9.4 ± 2.2 mL, 74 ± 10 rain and 17.2 ± 5.7 mL, respectively. One case suffered from tongue numbness which disappeared in 2 weeks. No facial and hypoglossal nerve paralysis occurred postoperatively. Compared with the control group, the incision length and bleeding dramatically decreased, while the difference of operational duration was not sig- metic results, which Endoscopeic resection of submandibular gland through a minimal incision could obtain better cos- is a feasible way to treat benign submandibular gland disease.