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目的:比较腮腺包膜外切除术(ECD)和腮腺切叶切除术(SP)术后复发和并发症的发生率,为临床治疗腮腺良性肿瘤选择合适的手术方式提供理论依据。方法:在Pubmed、中国期刊全文数据库(CNKI)和万方数据库检索比较SP和ECD手术方法转归的相关文献,采用RevMan 5.0软件进行Meta分析。结果:获得15篇文献用于Meta分析,共包括2 929例患者,其中1 796例接受ECD,1 133例接受SP。ECD和SP的术后复发率分别为1.29%(23/1 776)和1.48%(16/1 081),差异无统计学意义。ECD与SP术后暂时性面瘫的发生率分别为5.48%(74/1 350)和22.94%(139/606),永久性面瘫的发生率分别为0.66%(8/1 221)和2.71%(15/554),Frey综合征的发生率分别为1.91%(26/1 360)和16.71%(111/664),涎瘘的发生率分别为0.53%(5/946)和2.96%(10/338),与SP相比,ECD术后并发症的发生率明显降低。结论:与SP相比,ECD并发症发生率低,而肿瘤的复发率并没有增高,提示在适应证选择正确的情况下,ECD可以取代SP用于腮腺良性肿瘤的治疗。
Objective: To compare the incidence of postoperative recurrence and complications after parotidectomy (ECD) and parotidectomy (SP), and to provide a theoretical basis for the selection of suitable surgical approaches for the treatment of benign parotid tumors. Methods: We searched Pubmed, Chinese Journal Full-text Database (CNKI) and Wanfang database for Meta-analysis using RevMan 5.0 software. RESULTS: Fifteen articles were obtained for meta-analysis, comprising a total of 2 929 patients, of whom 1 796 received ECD and 1 133 received SP. Postoperative recurrence rates of ECD and SP were 1.29% (23/1 776) and 1.48% (16/1 081), respectively, with no significant difference. The incidences of temporary facial paralysis after ECD and SP were 5.48% (74/1 350) and 22.94% (139/606), respectively. The incidences of permanent facial paralysis were 0.66% (8/1 221) and 2.71% 15/554). The incidence of Frey syndrome was 1.91% (26/1 360) and 16.71% (111/664), respectively. The incidences of salivary fistula were 0.53% (5/946) and 2.96% (10 / 338), the incidence of postoperative ECD complications was significantly lower than that of SP. Conclusion: Compared with SP, the incidence of complications of ECD is low and the recurrence rate of tumors is not increased, suggesting that ECD can replace SP for the treatment of benign parotid tumors when the indications are correctly selected.