Does Shamblin's classification predict postoperative morbidity in carotid body tumors?: A proposal to modify Shamblin's classification
Does Shamblin's classification predict postoperative morbidity in carotid body tumors?: A proposal to modify Shamblin's classification
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DOI：
10.1007/s00405-005-0968-4
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发表时间：
2006-02-01
影响因子：
2.6
通讯作者：
Herrera-Gomez, A
中科院分区：
文献类型：
--
作者：
Luna-Ortiz, K;Rascon-Ortiz, M;Herrera-Gomez, A
本研究的目的是分析颈动脉体瘤（CBT）治疗中Shamblin分类与术后发病率之间可能的相关性。72例颈动脉体瘤患者在22年的时间内被观察到。23例患者因不符合目标标准而被排除。根据Shamblin分类法对所有患者进行分组。我们提出了一种改进的分类，并通过分析手术时间和出血，以及神经和血管损伤进行比较。我们切除了49例患者的50个CBTs，年龄从18岁到73岁不等。分为三组：I组8例（16%），II组17例（34%），III组24例（49%）。在I组1例患者（12.5%）、II组6例患者（35%）和III组9例患者（37.5%）中观察到术后神经系统损伤。21%的II级肿瘤和8.7%的III级肿瘤必须切除血管。I类肿瘤均不需要血管牺牲。与Shamblin分类相关的血管或神经系统风险无统计学显著差异。然而，当根据本文提出的分类进行分析时，Shamblin分类与血管处死之间存在相关性（P =0.001）。在手术时间和出血方面，原始Shamblin和改良Shamblin之间存在统计学显著相关性。Shamblin分类仅预测血管病变。神经系统的发病率并不反映在它，只反映了外科医生的经验与CBT切除。手术时间和出血与Shamblin直接相关，因为它反映了与血管相关的肿瘤大小。Shamblin分类法必须修改，使其更加客观，以便国际报告能够准确反映与之相关的发病率。
The objective of this study was to analyze the possible correlation between Shamblin's classification and post-surgical morbidity in the treatment of carotid body tumors (CBTs). Seventy-two patients with carotid body tumors were seen over a 22-year period. Twenty-three patients were excluded as they did not comply with the criteria of the objectives. All patients were grouped according to Shamblin's classification. We propose a modification to this classification and make a comparison by analyzing the surgical time and bleeding, as well as the neurological and vascular damage. We resected 50 CBTs in 49 patients, ranging in age from 18 to 73 years. Three groups were formed: group I with 8 (16%) patients, group II with 17 (34%) and group III with 24 (49%). Post-surgical neurological damage was observed in one patient (12.5%) from group I, in six (35%) from group II and in nine patients (37.5%) from group III. Vascular sacrifice had to be performed in 21% of class II tumors and in 8.7% of class III. None of the class I tumors required vascular sacrifice. No statistically significant difference existed for vascular or neurological risk in relation to Shamblin's classification. However, when analyzed according to the classification proposed herein, there was a correlation between Shamblin's classification and vascular sacrifice ( P =0.001). There was a statistically significant correlation between the original Shamblin and the modified Shamblin regarding surgical time and bleeding. Shamblin's classification predicts only vascular morbidity. Neurological morbidity is not reflected in it and only reflects the surgeon's experience with CBT resections. Surgical time and bleeding are directly related to the Shamblin as it reflects the size of tumors in relation to the blood vessels. Shamblin's classification must be modified to be more objective so that the international reports can accurately reflect the morbidity related to it.