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題 名 | Surgical Reconstruction for Buccal Cancer in Eastern Taiwan=東臺灣口腔頰部癌手術重建之經驗 |
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作 者 | 孫宗伯; 李俊達; 簡守信; | 書刊名 | 慈濟醫學 |
卷 期 | 11:2 1999.06[民88.06] |
頁 次 | 頁131-138 |
分類號 | 416.413 |
關鍵詞 | 口腔頰部癌; 重建手術; 存活率; Buccal cancer; Reconstruction; Survival rate; |
語 文 | 英文(English) |
中文摘要 | 目的:澄清並改善東臺灣地區口腔頰部癌手術重建之結果。病人及方法:自從 1989 年 12 月至 1997 年 8 月,有 80 住口腔頰部癌的病患於慈濟醫院接受手術治療。經 由查閱病歷而搜集病患的數目、性別、種族、嚼食檳榔與否、重建方法、組織學診斷及預後 狀況等資料並加以歸納分析。 結果:80 位病患中, 70 位為男性, 10 位為女性。 96%(n=77) 有嚼食檳榔之習慣,原住民僅 7 位,約佔 9%。此比例與花蓮縣政府官方資料原 住民佔總人口 23% 有相當大的出入。依據美國癌症聯合會 (American Joint Committee on Cancer,AJCC) 之分類,第一期 12 例,佔 15%;第二期 22 例,佔 28%; 第三期 16 例, 佔 20%:第四期 30 例,佔 38%。 的手術超過兩年的 54 位病患,其中 5 位失去追蹤,此 系列之兩年存活率, 對於早期癌 (第一及第二期 ) 與侵襲癌 (第三及第四期 ), 分別為 75.0% 與 48.3%(p<0.05)。共有 84 項重建手術施行,游離皮瓣 44 例;帶莖皮瓣 25 例; 裂層植皮 15 例。八成左右之病患,術後語言溝通皆無大礙,但五成左右之病患,有流口水 的困擾。結論:嚼食檳榔確實與口腔頰部癌之發生有高度的關聯性,早期發現,早期手術切 除及重建是為治療本疾病之準則,重建技術之進步得以做為更廣泛腫瘤切除之後盾,間接影 響病患之預後。 |
英文摘要 | Objective: To clarify and promote the outcome of surgical reconstruction for buccal cancer in eastern Taiwan. Patients and Methods: Eighty patients with buccal cancer had surgery at Buddhist Tzu-Chi General Hospital between December 1989 and August 1997. Charts of them were reviewed retrospectively. Data such as case number, sex, race, betel nut exposure, method of reconstruction, histology and outcome were collected and analyzed. Results: There were 70 male and 10 female patients, 77 of them (96%) had the habit of betel nut chewing. There were only seven aboriginal patients. The ratio between aboriginal and non-aboriginal patients was quite different from the local racial distribution between these ethnic groups in eastern Taiwan. The stages according to the American Joint Committee on Cancer (AJCC) staging were stage 1, 12 (15%); stage II, 22 (28%); stage III, 16 (20%); and stage IV, 30 (37%). Among 54 patients who had surgery more than 2 years, 5 patients were lost to follow-up. For this group of patients whose minimal follow-up was 2 years (n=49), the two-year-survival rate for early buccal cancer (stage I and II) was 75.0%, and for advanced disease (stage III and IV) it was 48.3%. Eighty-four reconstruction procedures were undertaken. There were 44 free flaps, 25 pedicle flaps and 15 split-thickness skin grafts. Forty-four percent of patients with local flap reconstructions and 57% of patients with free flap reconstructions had problems of drooling. Eighty-nine percent of patients with local flap reconstructions and 76% of patients with free flap reconstructions had a comprehensible speech. Conclusions: Betel nut chewing did correlate with the development of buccal cancer. Early detection and early surgical resection followed by reconstruction gives the best results in treatment for buccal cancer. Due to improvements in reconstruction techniques, more radical resection procedures could be done. |
本系統中英文摘要資訊取自各篇刊載內容。