关键词:

内镜手术, 腮腺, 免疫反应, 手术应激 ,

Abstract:

Objective To assess the clinical outcomes，postoperative immune response，and surgical stress of endoscope ⁃ assisted dissection for benign parotid tumors using hairline incision. Methods 47 patients with benign parotid tumors were enrolled and randomly divided into two groups. The patients in the endoscopy group（n = 25）underwent endoscopic⁃assisted dissection using hairline incision，while those in the control group （n = 22）underwent conventional open surgery. The postoperative complications，drainage，pain scores and satis⁃ faction of aesthetic outcomes were compared，and serum concentrations of IL⁃6，IL⁃8，IL⁃10，IL⁃1β，TNF⁃α， CRP，cortisol，ACTH and growth hormone were detected 12 hours（T1），24 hours（T2）and 72 hours（T3）after the procedure. The impacts of the procedure modes on postoperative immune response and surgical stress were assessed. Results The incision length in the endoscopy group was significantly shorter than that in the conventional group（P < 0.001），and the intraoperative blood loss in the endoscopy group was significantly lower than that in the conventional group（P = 0.004）. Patients in the endoscopy group were more satisfied with the postoperative cosmetic outcomes than those in the conventional group（P = 0.027）. However，the postoperative drainage volume was significantly higher in the endoscopy group than in the conventional group（P = 0.024），and the postoperative pain score was significantly greater in the endoscopy group than in the conventional group（P = 0.039）. Levels of IL ⁃6 and CRP in the endoscopy group at T1，T2 and T3 were significantly higher than those in the conventional group（P < 0.05），while levels of IL⁃10 and cortisol at T1 and T2 were significantly higher the endoscopy group than in the conventional group（P < 0.05）. Conclusions Endoscopy⁃assisted dissection for benign parotid tumors could improve cosmetic outcomes. Endoscopic procedures，compared with conventional surgery，resulted in a stron⁃ ger inflammatory response and higher surgical stress，as well as more postoperative pain and drainage.

Key words:

endoscopic surgery, parotid, immune response, surgical stress