口蓋垂口蓋咽頭形成術9年間の検討 : 同一術者による [in Japanese] Uvulopalatopharyngoplasty for a period of 9 years by one surgeon [in Japanese]
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一人の術者による9年間のUPPP経験例を術前・術後で検討し, 経験件数, 期間が手術効果に影響するか否かを調べた.1990年から1998年迄の9年間に術前と術後3～6ヵ月で終夜睡眠検査, 呼吸抵抗検査, 上気道MRI検査を施行した症例を検討した.症例を3年間毎に, I期 (n=23), II期 (n=10), III期 (n=16) に分けて検討した.I期ではAHI改善率=69.6%, II期では90%, III期では93.8%であった.I, II, III期の間の比較ではAHI改善率, 術後の口呼吸抵抗, 術後の咽頭腔左右径値が経験を積むほど有意によい結果を示した.
Uvulopalatopharyngoplasty (UPPP) performed by one surgeon for a period of 9 years was evaluated on the basis of preoperative and postoperative data to determine whether the number of UPPP the surgeon performed and the period of experience in performing them have any effects on the outcome of the surgery. We examined nocturnal sleep, respiratory resistance, and MRI of the upper airway in patients preoperatively and 3 to 6 months after surgery for the 9 year period from 1990 to 1998. The patients were divided into 3 groups according to the 3 year period in which they were treated: period I (n=23), period II (n=10), and period III (n=16). Among patients in period I, the AHI improvement rate was 69.6%, and the proportion of 25% or more improvement was 56.5%. Among those in period II, the AHI improvement rate was 90%, and the proportion of 25% or more improvement was 70%. Among those in period III, the AHI improvement rate was 93.8%, and the proportion of 25% or more improvement was 75%. Comparisons of the results among patients in periods I, II, and III showed that the surgeon's experience has significantly favorable effects on the AHI improvement rate, postoperative respiratory resistance through the mouth, and postoperative transverse diameter of the pharyngeal cavity. The number of cases in which UPPP was performed in period I was 46. The period and amount of experience in performing UPPP are therefore regarded as being a prerequisite for the surgeon to master the UPPP method.
Stomato-pharyngology 13(2), 243-250, 2001-02-28
Japan Society of Stomato-pharyngology