提出可行性,适用性,临床有效性,以及采用两阶段混合手术方法治疗复杂的ShamblinII或III颈动脉体瘤的结果。
回顾,观察,横截面,成功治疗16例困难的ShamblinII或III颈动脉体瘤的描述性研究,由两阶段手术方法组成。我们做了一个回顾,观察,横截面,一系列复杂的ShamblinII或III颈动脉体瘤患者的描述性研究,我们用两阶段混合手术治疗,我们首先放置了颈动脉内假体,45天后进行了肿瘤的手术切除,遵循我们最初发布的技术。这项研究从2月开始进行,2007年至11月,2019年,在三级护理中心。
我们治疗了16例患者,平均年龄为50.5岁。全部居住在海拔2000米以上。在所有16个中进行了完全切除。手术时间平均为103.9分钟,术中平均出血量为69ml。有3例神经性失用症。3例必须切开颈神经,2例永久性喉上神经损伤。内假体的放置没有永久性脑血管损伤。一名患者出现了短暂性脑缺血(TIA),没有长期后遗症。有2例无症状的内置假体晚期闭塞。肿瘤的平均初始体积为54.4cc。内假体植入后35天的平均肿瘤体积为30.9cc。
在所有病例和2例吞咽困难中,颈部存在肿瘤。
这种两阶段混合技术可以完全切除困难的ShamblinII或III颈动脉体肿瘤,1例TIA,2例永久性喉上神经损伤,无死亡。
Present the feasibility, applicability, clinical effectiveness, and results of complicated Shamblin II or III carotid body tumors treated with a two-stage hybrid surgical approach.
Retrospective, observational, cross-sectional, descriptive study of the successful treatment of 16 cases of difficult Shamblin II or III carotid body tumors, consisting of a two-stage surgical approach. We conducted a retrospective, observational, cross-sectional, descriptive study of a series of patients with complicated Shamblin II or III carotid body tumors, which we treated with a two-stage hybrid surgical procedure, in which we first placed a carotid endoprosthesis and 45 days later performed surgical resection of the tumor, following our originally published technique. This study was conducted from February, 2007 to November, 2019, in a third level care centre.
We treated 16 patients with a mean age of 50.5 years. All resided at more than 2000 meters above sea level. In all 16 a complete resection was performed. The average duration of surgery was 103.9 min, the average intraoperative bleeding was 69 ml. There were three cases of neuropraxia. The ansa cervicalis nerve had to be sectioned in three cases and there was permanent upper laryngeal nerve injury in two cases. There were no permanent cerebrovascular injuries from placement of the endoprostheses. One patient developed transient cerebral ischaemia (TIA) with no long-term sequelae. There were two cases of asymptomatic late occlusion of the endoprostheses. The average initial volume of the tumors was 54.4 cc. The average tumor volume 35 days after implant of the endoprosthesis was 30.9 cc.
Presence of tumors in the neck in all cases and two cases of dysphagia.
This two-stage hybrid technique allowed for the complete resection of difficult Shamblin II or III carotid body tumors, with one case of TIA and two with permanent upper laryngeal nerve injuries and without mortality.