摘要
目的:探讨舌癌根治术中不断开下颌骨的舌侧松解入路的手术方式,并评价其临床效果。方法:回顾性分析2016年7月~2017年12月于我院就诊的原发灶T2~T3期,未侵犯下颌骨的舌癌患者。比较采用断开下颌骨与不断开下颌骨的手术入路的两组患者术后疗效、生活质量及发生术后并发症的情况。结果:术后随访18~36个月,中位随访时间20个月。断开下颌骨组1例原发灶复发,发生在舌部原发灶基底部;不断开下颌骨组1例原发灶复发,同样发生在舌部原发灶基底部;两组患者均未出现颈部淋巴结复发及远处转移。术后1个月,不断开下颌骨组患者的咀嚼功能及外观评分均优于断开下颌骨组,差异有统计学意义(P<0.01);术后1年,不断开下颌骨组外观得分更优,差异有统计学意义(P<0.01)。结论:舌癌联合根治术中,适当的采用不断开下颌骨的舌侧松解入路,可以在保证手术的根治效果的同时,又能保留患者外形及咀嚼功能、降低术后并发症风险。
Objective:To explore the surgical approach of the lingual release approach of the mandible during radical resection of tongue cancer and to evaluate its clinical effect.Methods:A retrospective analysis of patients with tongue cancer who did not invade the mandible at stage T2~T3 of the primary tumors treated in our hospital from July 2016 to December 2017.The postoperative curative effect,life quality,and postoperative complications between the two groups of patients with temporary mandibulotomy and without mandibulotomy were compared.Results:The follow-up period was 18~36 months,and the median follow-up time was 20 months.One case of primary recurrence occurred in the basal area of tongue cancer in the temporary mandibulotomy group.One case of primary recurrence also occurred in the group without mandibulotomy and occurred at the base of the tongue cancer.There was no recurrence of cervical lymph nodes and distant metastasis observed.At 1 month after operation,the chewing function and appearance scores of patients in the group without mandibulotomy were better than those in the temporary mandibulotomy group,and the difference was statistically significant(P<0.01).One year after the operation,the appearance score was higher in the group without mandibulotomy,the difference was statistically significant(P<0.01).Conclusion:In the combined radical mastectomy of tongue cancer,the proper lingual release approach without mandibulotomy can be used to ensure the curative effect of the operation,while retaining the patient’s appearance and chewing function,and reducing the risk of postoperative complications.
作者
李殿奇
蒋梁
黄赐承
张广
邵乐南
周磊磊
LI Dian-qi;JIANG Liang;HUANG Ci-cheng;ZHANG Guang;SHAO Le-nan;ZHOU Lei-lei(Department of Stomatology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China.)
出处
《临床口腔医学杂志》
2020年第6期348-351,共4页
Journal of Clinical Stomatology
关键词
舌癌
下颌骨
唇
临床疗效
Tongue cancer
Mandible
Lip
Clinical effect
