上海口腔医学

上海口腔医学 ›› 2019, Vol. 28 ›› Issue (6): 616-621.doi: 10.19439/j.sjos.2019.06.012

• 论著 • 上一篇    下一篇

颊颈连续曲线切口在颊癌联合根治术中的应用效果评价

姚又丹, 李大帅, 杨蓉, 吴晓珊, 高兴, 郭峰   

  1. 中南大学湘雅医院 口腔医学中心,口腔颌面外科,湖南 长沙 410008
  • 收稿日期:2019-04-17 出版日期:2019-12-25 发布日期:2020-01-14
  • 通讯作者: 郭峰,E-mail：dentguo@126.com
  • 作者简介:姚又丹（1994-）,女,硕士,E-mail：Zoey2yd@outlook.com
  • 基金资助:
    国家自然科学基金（81974150）

Evaluation of continuous curvilinear buccal-cervical incision in combined radical resection of buccal cancer

YAO You-dan, LI Da-shuai, YANG Rong, WU Xiao-shan, GAO Xing, GUO Feng   

  1. Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University. Changsha 410008, Hunan Province, China
  • Received:2019-04-17 Online:2019-12-25 Published:2020-01-14

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摘要： 目的 探讨并评估颊颈连续曲线切口在颊癌联合根治术中的应用效果。方法 收集2015年1月—2018年12月收治的颊癌患者87例,其中42例采用颊颈连续曲线切口（实验组）,45例采用传统颈部T形切口联合面颊切口（对照组）。评估术野暴露范围,对比2组切口长度、联合根治术所耗时长和术后颈部并发症发生率。随访时间7~43个月,采用改良温哥华瘢痕量表（Vancouver Scar Scale,VSS）及华盛顿大学生存质量问卷（University of Washington Quality of Life,UW-QOL）,对2组患者术后瘢痕及生存质量进行评估。采用SPSS 22.0软件包进行统计学分析。结果 实验组切口长度为（36.40±5.08）cm,显著小于对照组的（39.93±5.22）cm（P<0.05）;实验组联合根治术所耗时长短于对照组,颈部并发症发生率低于对照组;术后瘢痕评估及生存质量优于对照组,差异均有统计学意义（P<0.05）。2组手术术野显露范围,术后复发、转移率无显著差异。结论 颊颈连续曲线切口与传统切口相比,能获得良好的视野,联合根治耗时短,并能实现原发灶与颈淋巴清扫术整体切除以保证手术彻底性。具有切口短且美观、并发症少、术后生存质量好等优点,是值得推荐的一种颊癌联合根治手术切口。

关键词: 颊癌, 颊颈连续曲线, 手术切口, 效果评价

Abstract: PURPOSE: To evaluate the clinical effect of continuous curvilinear buccal-cervical incision in combined radical resection of buccal cancer. METHODS: From January 2015 to December 2018, a total of 87 patients with buccal cancer were collected, of whom 42 underwent continuous curvilinear buccal-cervical incision (experimental group) and 45 underwent conventional cervical T shaped incision combined with a buccal incision (control group). Exposure of surgical filed in two groups was evaluated. The length of incision, duration of radical resection, and the incidence of postoperative complications were compared between two groups. The patients were followed-up for 7-43 months. Modified vancouver scar scale (VSS) and University of Washington Quality of Life (UW-QOL) were used to evaluate the postoperative scar and quality of life in both groups. Statistical analysis was performed on the data using SPSS 22.0 software package. RESULTS: The length of the incision in the experimental group was (36.40±5.08) cm, which was shorter than that of the control group (39.93±5.22) cm. Duration of combined radical resection in the experimental group was shorter than that of the control group. The incidence of neck complications in the experimental group was lower than that of the control group. The postoperative scar assessment and quality of life of the experimental group were better than that of the control group. The difference was statistically significant (P<0.05). There was no significant difference between the two groups in terms of the exposure of the surgical field, postoperative recurrence and metastasis rate. CONCLUSIONS: Continuous curvilinear buccal-cervical incision has good exposure of the surgical field and shorter duration of radical resection, which ensures en bloc resection of tumor and cervical lymph nodes. It limits the formation of skin cicatrix, reduces the occurrence of postoperative complications and results in a good aesthetic and functional effect, therefore it is a recommended incision for clinical practice.

Key words: Buccal cancer, Buccal-cervical continuous curvilinear incision, Surgical incision, Effect evaluation

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