目的 :总结复发性腮腺多形性腺瘤的手术治疗经验,分析其预后影响因素。方法 :回顾分析2010年1月—2015年1月于我院手术治疗的39例复发性腮腺多形性腺瘤患者的临床特点、手术方法、并发症、术后随访情况,采用SAS9.0软件包,运用Kaplan-Meier法及Log-rank分析其预后影响因素。结果 :39例患者中,女14例(35.89%),男25例(64.10%);年龄31-72岁(中位年龄45岁)。对其中26例(66.66%)采用腮腺全叶切除术治疗,11例(28.21%)采用腮腺浅叶切除术,2例(5.13%)采用腮腺部分切除术。6例患者因肿瘤黏连面神经,手术中予以部分切除。主要并发症为暂时性面瘫(29例,74.36%)及Frey综合征(9例,23.08%)。中位随访时间为2.1年,其中3例再次复发。预后与肿瘤大小及手术方式密切相关。结论:复发性腮腺多形性腺瘤手术预后与肿瘤大小及手术方式密切相关,建议采用浅叶或全叶切除术。神经往往与复发病灶关系密切,术中易造成神经损伤,必要时需要修复,术后定期随访十分重要。
PURPOSE: To investigate the prognostic factors after surgical treatment of recurrent pleomorphic adenoma. METHODS: We retrospectively analyzed 39 patients diagnosed with recurrent pleomorphie adenoma who received surgical treatment in our hospital from January 2010 to January 2015. Clinical variables, imaging features and surgical outcomes were analyzed using SAS 9.0 software package. RESULTS: Among 39 patients, 14 (35.89%) were female while 25 (64.10%) were male. Their age ranged from 31 to 72 years old (median: 45). 66.66% (n=26) of the patients underwent total parotideetomy, while 11 patients (28.21%) underwent superficial parotideetomy and 2 (5.31%) with partial parotidectomy. Facial nerves were sacrificed in 6 patients due to nerve invasion by tumors. Postoperative complications were reported as temporary palsy (n=29, 74.36%) and Frey's syndrome (n=9, 23.08%). Median follow-up time was 2.1 years, during which 3 patients re-recurred. CONCLUSIONS: Recurrent pleomorphic adenoma is challenging from a surgical standpoint. Facial nerves are closely involved with these neoplasms. Close follow-up is necessary after operation.