이하선 왈틴씨 종양의 수술방법으로서 종양적출술에 대한 평가
Enucleation for the Management of the Parotid Warthin’s Tumor
권기환, 서진학, 허민희, 정웅윤, 강혜윤, 박정수,
소속 상세정보
권기환 ( Kwon Ki-Hwan )
연세대학교 의과대학 외과학교실
서진학 ( Suh Jin-Hak )
연세대학교 의과대학 외과학교실
허민희 ( Hur Min-Hee )
성균관대학교 의과대학 삼성제일병원 일반외과
정웅윤 ( Chung Woong-Youn )
연세대학교 의과대학 외과학교실
강혜윤 ( Kang Hae-Youn )
연세대학교 의과대학 병리학교실
박정수 ( Park Cheong-Soo )
연세대학교 의과대학 외과학교실
KMID : 0371320010610050474
Abstract
>Purpose : Warthin’s tumor is a slow growing tumor found exclusively either in the parotid gland or the periparotid lymph nodes. Although surgical resection is the treatment of choice, the extent of surgery which is most beneficial has
remained
contraversial. We performed a comparative study of the results between enucleation and parotidectomy groups to evaluate the effectiveness of the enucleation procedure for the surgical management of parotid Warthins tumor.
Methods : Between January 1981 and July 2001, 74 patients underwent surgical resection of parotid Warthin’s tumor. We reviewed the clinicopathological characteristics retrospectively and compared the operation time, postoperative
complication
rate, duration of postoperative hospital stay and recurrence between the enucleation group and the parotidectomy group.
Results : The mean age was 57.0 years (19∼86 years) and the male to female ratio was 5.7：1. The majority of the tumors were situated in the lower region of the superficial lobe (89.2%). Bilateral simultaneous involve ments of the parotid
gland
was found in 5 patients (6.8%) and therefore a total of 79 parotid glands were involved. Four (5.4%) of the 79 parotid glands featured multifocal tumors of two or three lumps. Tumor sizes varied from 0.5 to 13.0 ㎝ with a mean diameter of 3.5 ㎝.
Of the
74 patients, 51 (68.9%) were diagnosed preoperatively or perioperatively by means of CT scans, ultrasound, 99m-Tc. scan, fine needle aspiration cytology or intraoperative frozen section biopsy. Of the 79 glands, 46 underwent a superficial (n=39),
partial (n=2) or total (n=5) parotidectomy, while enucleation was performed for the remaining 33 cases with single Warthin’s tumor. Only one case of recurrence was identified during the follow up period. However the operation time, the
postoperative
complication rate, and the duration of postoperative hospital stay were all significantly reduced in the enucleation group (P<0.05).
Conclusion : The enucleation procedure may represent a safe and appropriate surgical method for patients with single Warthin’s tumor that is diagnosed preoperatively.
키워드
이하선 왈틴씨 종양; 종양적출술; 이하선 절제술; Parotid Warthin’s tumor; Enucleation; Parotidectomy;
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