小钳口LigaSure在腮腺肿瘤切除术中的应用

Application of LigaSure small jaw in parotidectomy for tumors

摘要:

目的 探讨小钳口LigaSure在腮腺深浅叶良恶性肿瘤切除术中的应用。方法 前瞻性的纳入西安交通大学第二附属医院耳鼻咽喉头颈外科病院2016年1月—2018年12月行腮腺来源肿瘤接受手术的47例患者，分为利用LigaSure切除（A组）27例及电刀结合传统刀片切除（B组）20例。对两组间的手术时间、术中出血量、术后48 h引流量及术后并发症进行比较。结果 A组的手术时间（85.56±43.94）min与B组（123.00±44.14）min相比，明显缩短（P<0.05）；两组术中出血量[（46.67±42.34）mL vs（75.00±49.92）mL]比较，差异具有统计学意义（P<0.05）；两组术后引流量[（38.15±17.16）mL vs（63.25±21.59）mL]比较，差异有统计学意义（P<0.05）；两组间术后并发症各参数无统计学差异。浅叶切除中A组和B组手术时间[（70.00±17.54）min vs（104.00±25.58）min]，术中出血量[（33.81±21.79）mL vs（54.67±19.32）mL]及术后引流量[（32.62±11.36）mL vs（54.33±8.84）mL]比较，差异均具有统计学意义（P均<0.05）。腮腺全切（包括扩大切除）术中使用LigaSure的患者手术时间，术中出血量及术后引流量与对照组比较，差异均无统计学意义（P均>0.05）。结论 小钳口LigaSure在切除腮腺良恶性肿瘤的应用是安全的，与传统手术方式相比尤其在浅叶手术中LigaSure有出血少，手术时间短等优势。

关键词:腮腺手术;LigaSure;常规止血;并发症

Abstract:

Objective To evaluate the application of LigaSure small jaw in superficial or total parotidectomy for parotid tumors.Methods This was a prospective study on 47 patients undergoing superficial or total parotidectomy for parotid tumors in the Hospital of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University from Jan 2016 to Dec 2018. All the patients were divided into two groups: 27 patients in group A had LigaSure small jaw parotidectomy, and 20 in group B had conventional parotidectomy. The operation time, amount of bleeding, volume of drainage within 48 hours after surgery and postoperative complications between the two groups were assessed and compared.Results Operation time was significantly shorter in group A (85.56±43.94)min than in group B (123.00±44.14)min (P<0.05). Group A was associated with a significant reduction in intraoperative blood loss (46.67±42.34)mL vs (75.00±49.92)mL(P< 0.05). The different amount of postoperative drainage (38.15±17.16)mL vs (63.25±21.59)mL(P<0.05) was noted between the two groups. No significant differences were observed between group A and B with respect to complications. Use of LigaSure in superficial parotidectomy compared to conventional surgery was associated with a significant reduction in intraoperative blood loss (33.81±21.79)mL vs (54.67±19.32)mL, operation time (70.00±17.54)min vs (104.00±25.58)min and the amount of postoperative drainage (32.62±11.36)mL vs (54.33±8.84)mL. In patients undergoing total parotidectomy, no significant differences of parameters were observed between the two groups.Conclusion Use of the LigaSure in the surgical treatment of parotid tumors is safe, and has some advantages over conventional methods in operation time, intraoperative blood loss and postoperative drainage, especially in superficial parotidectomy.

Key words:Parotidectomy;LigaSure;Conventional hemostasis;Complication