保留器官的显微手术治疗腮腺涎腺多形性腺瘤

D. Steblovsky
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引用次数: 0

摘要

在唾液腺肿瘤的总数中,76.4-90%的病例受肿瘤进程影响的是腮腺。在腮腺良性肿瘤中,多形性腺瘤是最常见的肿瘤(61.2-90%)。本研究的目的是开发和应用于临床条件下的腮腺多形性腺瘤器官保留手术的显微外科方法,确定采用特定手术治疗方法的主要临床适应症,降低术后并发症的发生风险。本研究的材料是基于在MI“Poltava M.V. Sklifosovskyi地区临床医院”颌面外科门诊对90例腮腺多形性腺瘤进行手术治疗的结果。术前诊断依据临床检查、腮腺超声、磁共振计算机断层扫描结果以及肿瘤穿刺活检所获材料的细胞学检查。80例患者肿瘤位于腮腺浅表部,7例患者位于腮腺深部。2例患者肿瘤几乎累及整个腺体;在1例患者中,注意到腺体浅部和深部肿瘤过程的多结节性。根据所进行的研究,我们认为,使用显微外科手术原理对腮腺进行部分切除,可以扩大对腮腺表面多形性腺瘤进行该手术的普遍接受适应症(肿瘤大小不超过2厘米)。在我们看来,使用这种手术的主要标准是肿瘤的绝对大小和肿瘤累及腮腺浅表部分的相对百分比。如果检查结果显示肿瘤没有占据腺体的整个表层,在保留部分腺体的同时可以在健康组织的范围内切除,则应优先采用这种方法,而不是部分切除腺体。通常,当此类肿瘤(大于2厘米)位于腺体的两极区域时,这是可能的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ORGAN-PRESERVING MICROSURGERY FOR PLEOMORPHIC ADENOMA OF THE PAROTID SALIVARY GLAND
Of the total number of salivary gland tumors, the parotid gland is affected by the tumoral process in 76.4–90% of cases. Among benign tumors of the parotid gland, the most frequent tumor (61.2–90%) is pleomorphic adenoma. The aim of the research is to develop and apply in clinical conditions microsurgical methods of organ-preserving surgery for pleomorphic adenomas of the parotid gland, to determine the main clinical indications for the use of a specific method of surgical treatment, to reduce the risk of developing postoperative complications. The material of this study is based on the results of the surgical treatment of 90 patients with pleomorphic adenomas of the parotid gland, which was carried out in the clinic of maxillofacial surgery on the basis of the Department of Maxillofacial Surgery of MI “Poltava M.V. Sklifosovskyi Regional Clinical Hospital”. Preoperative diagnosis was made on the basis of clinical examination, results of ultrasound and magnetic resonance computer tomography of the parotid glands, as well as the cytological examination of material obtained during puncture biopsy of the tumor. In 80 patients, the tumor was localized in the superficial part, and in 7 patients – in the deep part of the parotid gland. In 2 patients, there was total tumor damage to almost the entire gland; in 1 patient, the multinodular nature of the tumor process in both the superficial and deep parts of the gland was noted. As a result of the conducted research, we believe that performing a partial resection of the parotid gland using microsurgical principles of the operation allows us to expand the generally accepted indication (tumors up to 2 cm in size) for performing this operation for pleomorphic adenomas of the superficial part of the gland. In our opinion, the main criterion for the use of this operation is the absolute size of the tumor and the relative percentage of tumor involvement in the superficial part of the parotid gland. If the results of the examination show that the tumor does not occupy the entire superficial part of the gland, and it can be removed within the limits of healthy tissues while preserving some part of the gland, preference should be given to this method, rather than subtotal resection of the gland. As a rule, this is possible when such tumors (more than 2 cm) are localized in the region of the poles of the gland.
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