背景:颈动脉体瘤(CBT)是罕见的,但由于其生长和恶性的潜力,需要手术切除。对于一些手术团队来说,肿瘤血管过多证明术前栓塞是合理的,以促进切除和限制并发症。我们研究的目的是在双中心队列中评估两种不同的手术切除方法,包括或不包括术前栓塞。
方法:连续一系列接受CBT手术的患者,从2011年1月到2019年6月,分为两组,术前是否栓塞(ECBT)或是否栓塞(NECBT)。两组根据手术时间进行具体比较,术后并发症,和逗留时间的长短。
结果:纳入22例患者,平均年龄为48.5±14.3岁。在该系列中,切除23例CBT:术前栓塞13例;栓塞和手术之间的平均时间为2.62天±1.50。根据人群和肿瘤的特征,两组具有可比性。平均尺寸为33.2±11.9毫米。我们注意到ECBT组手术时间显着增加:151分钟(±40.9)vs87.0分钟(±21)p<0.01。两组在颅神经方面没有差异(50%vs46%;p=1),交感神经系统(20%对23%;p=1),或血管神经(20%vs23%;p=0.18)并发症。未发现脑血管意外。住院时间分别为3.60天(±1.78)和3.73天(±1.19;p=0.44)。
结论:本研究反映了两个中心管理CBT的经验,CBT是一种罕见的病理,没有标准化治疗。我们的系列研究显示,ECBT和NECBT组在术后并发症和住院时间方面没有显着差异。NECBT组的运行时间减少仍有待证明。
BACKGROUND: Carotid body tumors (CBTs) are rare but require surgical resection given their potential for growth and malignancy. For some surgical teams, tumor hypervascularity justifies preoperative embolization to facilitate resection and limit complications. The objective of our study was to evaluate 2 different practices of surgical resection with or without preoperative embolization in a 2-center cohort.
METHODS: A consecutive series of patients who underwent CBT surgery, from January 2011 to June 2019, were divided into 2 groups, as to whether they were (embolized CBT [ECBT]) or not (nonembolized CBT [NECBT]) preoperatively embolized. Both groups were compared specifically according to the duration of operation, postoperative complications, and length of stay.
RESULTS: Twenty-two patients with a mean age of 48.5 ± 14.3 years were included. In the series, 23 CBTs were resected: 13 were embolized preoperatively; the mean time between embolization and surgery was 2.62 ± 1.50 days. Both groups were comparable based on characteristics of population and tumor, with a mean size of 33.2 ± 11.9 mm. We noted a significant increase in operation duration in the ECBT group: 151 min (±40.9) vs. 87.0 min (±21); P < 0.01. There was no difference between the 2 groups regarding cranial nerve (50% vs. 46%; P = 1), sympathetic nervous system (20% vs. 23%; P = 1), or vascular nerve (20% vs. 23%; P = 0.18) complications. No cerebrovascular accident was identified. The length of stay was 3.60 days (±1.78) vs. 3.73 days (±1.19; P = 0.44).
CONCLUSIONS: This study reflects the experience of 2 centers in the management of CBT which is a rare pathology with no standardized treatment. Our series showed no significant difference between the ECBT and NECBT groups regarding postoperative complications and length of hospital stay. The reduction in operating time in the NECBT group remains to be demonstrated.