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目的:内镜辅助下或依靠机器人经耳后径路或其改良径路行早期口腔癌(c T1-2N0)的择区性颈淋巴清扫术(selective neck dissection,SND)已有报道,然而,此种术式所带来的美观效果是以较大的手术创伤为代价。本文探讨内镜辅助下经下颌下径路行早期口腔癌(c T1-2N0)SND的手术创伤和美观效果。方法:54例早期口腔癌患者(c T1-2N0)随机分为内镜组和开放组2组。对患者围术期和术后相关指标进行评估,包括颈清扫切口长度、颈清扫时间、术中出血量;术后引流量和引流时间、总住院时间、清扫淋巴结数目、患者美观满意度、围术期并发症、肩部功能和随访情况。结果:内镜组平均手术时间为(124.04±13.47)min,较开放组(73.47±15.36)min长。但内镜组平均切口长度仅为(4.23±0.56)cm,同时术后引流量和引流时间、总住院天数、术后肩部疼痛程度和美观效果均较开放组为优,而且2组清扫的淋巴结数目无显著差别。结论:内镜辅助下经下颌下径路行SND的时间较开放组长,但手术创伤小,美观效果好。
OBJECTIVE: Selective neck dissection (SND) assisted by endoscopy or assisted by robotic approach of ear passage or modified approach to early stage oral cancer (c T1-2N0) has been reported. However, The aesthetic effect brought by surgery is the cost of larger surgical trauma. This article investigates the surgical trauma and aesthetic effect of endoscopic-assisted SND of the early stage of oral cancer (subtypes of submandibular pathways). Methods: 54 patients with early stage oral cancer (c T1-2N0) were randomly divided into two groups: endoscopic group and open group. Perioperative and postoperative related indicators were evaluated, including the length of neck dissection, neck dissection time, intraoperative blood loss; postoperative drainage and drainage time, total length of hospital stay, the number of lymph nodes dissection, patients with aesthetic satisfaction, Wai Complications, shoulder function and follow-up. Results: The average operation time of endoscopic group was (124.04 ± 13.47) min, which was longer than that of open group (73.47 ± 15.36) min. However, the mean incision length of the endoscopic group was only (4.23 ± 0.56) cm, meanwhile drainage and drainage time, total length of hospital stay, degree of postoperative shoulder pain and aesthetic effect were better than those in the open group, No significant difference in the number of lymph nodes. Conclusion: Endoscopic assisted submandibular approach to SND is more time-consuming than open-ended surgery, but the surgical trauma is small and the aesthetic effect is good.