通过比较内窥镜辅助经口入路(EATA)和外部入路(EA)切除咽旁间隙肿瘤(PPST),我们确定了EATA在运行时间方面是否具有优势,术中出血量,术后住院,排水量,和并发症。同时,我们总结了EATA的手术适应证。
在PubMed中进行了系统的文献检索,WebofScience,Embase,CNKI,万方,以及截至2020年2月的CQVIP数据库。我们计算了连续结局的95%置信区间(CI)的平均差(MD)和二分结局的95%CI的合并比值比(OR)。测量的结果是手术时间,出血量,术后住院,排水量,和并发症。
7项研究纳入了318名患者。在这些病人中,145例患者接受了EATA手术,173例患者接受了EA手术。除未记录的肿瘤外,所有前肿瘤均为良性,位于颈动脉鞘的内侧或内侧。与EA相比,EATA显著缩短了手术时间(MD=-5.56分钟,95%CI:-9.58至-1.55),缩小出血量(MD=-89.02ml,95%CI:-126.16至-51.88),缩短了术后住院时间(MD=-2.44天,95%CI:-3.37至-1.51),减少了引流量(MD=-32.97ml,95%CI:-36.24至-29.70),降低并发症发生率(OR=0.30,95%CI:0.16~0.59)。
至于PPST,通过适当和精确的患者选择,EATA是个保险箱,有效,微创,和美学手术方式。喉镜,131:2246-2253,2021。
By comparing the endoscopy-assisted transoral approach (EATA) with external approaches (EAs) for the resection of parapharyngeal space tumors (PPSTs), we determined whether the EATA has advantages in terms of operation time, intraoperative bleeding volume, postoperative hospitalization, drainage volume, and complications. At the same time, we summarized the surgical indications for the EATA.
Systematic literature retrieval was performed in the PubMed, Web of Science, Embase, CNKI, Wanfang, and CQVIP databases up to February 2020. We calculated the mean difference (MD) with a 95% confidence interval (CI) for continuous outcomes and pooled odds ratio (OR) with 95% CI for dichotomous outcomes. The measured outcomes were operative time, bleeding volume, postoperative hospitalization, drainage volume, and complications.
Seven studies involving 318 patients were eligible. Of these patients, 145 patients underwent EATA and 173 patients underwent EA surgery. All the former tumors were benign and located medial or anteromedial to the carotid sheath except for the unrecorded tumors. Compared with EAs, the EATA significantly shortened the operation time (MD = -5.56 min, 95% CI: -9.58 to -1.55), shrank the bleeding volume (MD = -89.02 ml, 95% CI: -126.16 to -51.88), shortened the postoperative hospitalization (MD = -2.44 days, 95% CI: -3.37 to -1.51), reduced the drainage volume (MD = -32.97 ml, 95% CI: -36.24 to -29.70), and lowered the incidence of complications (OR = 0.30, 95% CI: 0.16 to 0.59).
As for PPSTs, with an appropriate and precise patient selection, the EATA is a safe, effective, minimally invasive, and aesthetic surgical modality. Laryngoscope, 131:2246-2253, 2021.