包膜外切除术治疗腮腺下极良性肿物的临床应用分析

Extracapsular dissection of parotidectomy in parotid benign tumor

目的探讨应用包膜外切除术治疗腮腺下极良性肿瘤的临床疗效。方法回顾性分析2000年~2010年收治的腮腺下极良性结节患者151例。151例患者均于术前或术中冰冻明确为良性。其中91例行腮腺肿物包膜外切除术,60例行腮腺浅叶切除术＋面神经解剖术。结果所有手术均顺利完成,平均手术时间对照组为112.5±20.3 min,观察组为71.5±13.5 min,差异有统计学意义（P〈0.05）。所有患者术后随访4~14年,平均7.6年。在术后并发症方面,观察组术后涎瘘、暂时性面瘫、口干和Frey’s综合征等总发生率低于对照组,差异有统计学意义（P〈0.05）。观察组患者对切口瘢痕满意度为97.8%,高于对照组的86.7%;观察组患者暂时性面瘫恢复时间也短于对照组,差异均有统计学意义（P〈0.05）。两组复发率无显著差异。结论对于腮腺下极良性小结节患者,腮腺肿物包膜外完整切除术可以高效、安全的切除肿物,减少术后并发症的发生。

Objective To evaluate and compare the clinical results of extracapsular dissection and superficial parotidectomy. Methods 151 patients who underwent excision of the parotid benign tumor between 2000 and 2010 were reviewed. Of them, 91 patients underwent extracapsular dissection and 60 patients received superficial parotidectomy. All patients were followed up for 4 to 14 years. Results Surgical complications （facial paralysis, Frey＇s syndrome and salivary fistula） were lower in extracapsular dissection than in superficial parotidectomy, but the recurrence rate was not significantly different between two surgical modalities. Conclusion Extracapsular dissection could retain more parotid gland tissue,had less complications and can be the first choice for the treatment of parotid benign tumor.