华西口腔医学杂志

• 内镜辅助手术专栏 • 上一篇    下一篇

采用双内镜微创治疗下颌下腺深部结石

汪为庆 谢磊   

  1. 浙江大学医学院附属邵逸夫医院头颈外科,杭州 310016
  • 收稿日期:2015-11-05 修回日期:2016-01-02 出版日期:2016-04-01 发布日期:2016-04-01
  • 通讯作者: 谢磊,主任医师,博士,E-mail:raycate2004@yahoo.com.cn
  • 作者简介:汪为庆,住院医师,硕士,E-mail:wwq1200@163.com

Minimally invasive bi-endoscopic treatment of deep submandibular gland calculu

Wang Weiqing, Xie Lei.   

  1. Dept. of Head and Neck Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
  • Received:2015-11-05 Revised:2016-01-02 Online:2016-04-01 Published:2016-04-01
  • Contact: Xie Lei, E-mail: raycate2004@yahoo.com.cn.

摘要:

目的 评价涎腺内镜配合常规30°角腔镜在下颌下腺深部结石中的临床应用。方法 选择2013年6月—2015年8月因单侧颌下区反复肿胀就诊患者17例,术前经下颌骨CT和唾液腺功能显像检查,诊断为下颌下腺深部结石。17例患者男性13例,女性4例,左侧12例,右侧5例;均应用涎腺内镜辅助常规30°角腔镜行口内取石术。结果 下颌骨CT显示17例患者均有下颌下腺深部阳性结石,唾液腺功能检查显示患侧摄锝功能基本正常,而排泌功能明显下降。17例患者均采用双内镜辅助手术方法成功通过口内取出结石,手术时间(42±21)min,围手术期无明显并发症。结论 双内镜辅助下行下颌下腺深部结石取出手术是一种有应用前景的新技术,可以避免因早期深部结石造成的腺体切除,但目前仍需严格选择适应证。

关键词: 涎腺内镜, 涎石病, 腔镜手术

Abstract:

Objective  A study was conducted to evaluate the clinical application of sialendoscopy combined with conventional laparoscopy in a 30 degree angle in depth salivary calculus of submandibular glands. Methods  A total of seventeen patients were presented with repeated swelling in the unilateral submandibular area from June 2013 to August 2015. All patients underwent CT examinations of the mandible and salivary gland function imaging preoperatively. Sialoendoscopy and conventional endoscopy were applied to do intraoral lithotomy. Among the study group, thirteen cases were males and four cases were females. A total of twelve were left cases and five were right cases. Results Seventeen patients had deep positive calculus in the submandibular glands under CT. Photo technetium function was basically normal, whereas secretion of ipsilateral decreased significantly in salivary function tests. Double endoscope assisted surgeries were performed successfully through the mouth to remove the stones. The operation time was (42+21) min. There were no obvious complications in perioperative periods. Conclusion Intraoral lithotomy assisted by sialoendoscopy and conventional laparoscopy for deep stones in the submandibular glands is a new technique. This technique will possibly lead to complete avoidance of gland resection because of early deep sialolithiasis.

Key words: sialoendoscopy, ptyalolithiasis, endoscopic operation