内窥镜辅助传统手术与传统手术治疗鼻窦恶性黑色素瘤的疗效分析

Xuezhong Dai,Xia Er,Yang Zhou,Liming Cui,Liping Li
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摘要

研究目的分析传统手术和内窥镜辅助传统手术对鼻窦恶性黑色素瘤(SMM)患者的治疗效果,探讨SMM的有效治疗方法。方法回顾性分析2000年10月至2020年6月在云南省第三人民医院耳鼻咽喉头颈外科确诊的47例SMM患者的临床病理资料和手术方法。其中,26 例采用传统手术治疗,21 例采用内窥镜辅助传统手术治疗。对3年和5年的局部复发率和生存率进行了监测和比较。结果显示两组 3 年局部复发率比较:χ2 = 5.4558,P = .020 (P < .05),内镜辅助传统手术组 3 年局部复发率较低。两组 3 年生存率比较:χ2 = 1.0231,P = .312 (P > .05),两组 3 年生存率差异无显著性。两组 5 年局部复发率比较:χ2 = 4.4052,P = .036 (P < .05),内镜辅助传统手术组 5 年局部复发率较低。两组患者的 5 年生存率比较:χ2 = 4.3085,P = .038(P < .05),内镜辅助传统手术组的 5 年生存率更高。因此,内镜辅助传统手术与传统手术治疗 SMM 的 3 年和 5 年局部复发率以及 5 年生存率存在显著差异。结论内镜辅助传统手术能更彻底地切除SMM的局部病灶,降低局部复发率,提高患者的5年生存率。
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Efficacy Analysis of Endoscopic-Assisted Traditional Surgery and Traditional Surgery for Sinonasal Malignant Melanoma.
Object: To analyze the effect of traditional surgery and endoscope-assisted traditional surgery on patients with sinonasal malignant melanoma (SMM), and to explore the effective treatment of SMM. Methods: The clinicopathological data and surgical methods of 47 patients with SMM, diagnosed in the Department of Otorhinolaryngology-Head and Neck Surgery at the Third People's Hospital of Yunnan Province from October 2000 to June 2020, were retrospectively analyzed. Among them, 26 cases were treated with traditional surgery, and 21 cases were treated with endoscope-assisted traditional surgery. The 3 and 5 year local recurrence and survival rates were monitored and compared. Results: The 3 year local recurrence rate was compared between the 2 groups: χ2 = 5.4558, P = .020 (P < .05), the endoscope-assisted traditional surgery group had a lower 3 year local recurrence rate. The 3 year survival rate was compared between the 2 groups: χ2 = 1.0231, P = .312 (P > .05), the difference in 3 year survival was not significant between the 2 groups. The 5 year local recurrence rate was compared between the 2 groups: χ2 = 4.4052, P = .036 (P < .05), the endoscope-assisted traditional surgery group had a lower 5 year local recurrence rate. The 5 year survival rate was compared between the 2 groups: χ2 = 4.3085, P = .038 (P < .05), the endoscope-assisted traditional surgery group had a higher 5 year survival rate. Therefore, there were significant differences in the local recurrence rates at 3 and 5 years, as well as the 5 year survival rate, between endoscope-assisted traditional surgery and traditional surgery in the treatment of SMM. Conclusion: Endoscope-assisted traditional surgery can remove local lesions of SMM more completely, reduce the local recurrence rate, and improve the 5 year survival rate of patients.
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