经胸壁入路腔镜甲状腺切除术与开放手术的临床对比分析  

Clinical comparative study between the transthoracic approach endoscopic thyroidectomy and open surgery

作　　者：刘洪涛[1] 蔡相军[1] 刘亮[1] 王斌[1] 印慨[2] 郑成竹[2] 

机构地区：[1]解放军第202医院普外科,沈阳110812 [2]上海第二军医大学附属长海医院普外科,200433

出　　处：《中华腔镜外科杂志（电子版）》2014年第5期19-22,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：辽宁省博士科研启动基金资助项目(No.20101128)

摘　　要：目的比较完全腔镜与常规开放甲状腺切除术之间的差别,探讨腔镜下甲状腺手术的可行性和实用性。方法选择甲状腺良性肿瘤130例,随机分为经胸壁入路腔镜甲状腺切除术58例(腔镜组)和开放切除术72例(开放组)。观察比较两组手术时间、术中出血量、术后住院时间、术后引流量、引流时间、住院费用、术后美容效果、术后并发症发生情况、术后疼痛评分及患者满意度等。结果开放组住院时间、切口长度显著多(长)于腔镜组(P<0.05),出血量、手术时间、拔管时间、住院费用、引流量、术后疼痛VAS分值显著少(短)于腔镜组(P<0.05)。两组术后并发症发生率、肿瘤复发率比较,差异无统计学意义。腔镜组患者美观满意度显著高于开放组(P<0.05)。结论经胸壁入路腔镜甲状腺切除术临床效果优于开放切除术,在严格把握手术适应证的情况下是值得推崇的手术方式。Objective To compare the differences between total endoscopic and conventional open thyroidectomy,as well as exploring the feasibility and efficacy of endoscopic surgery.Methods 130 cases of benign thyroid were chosen randomly and divided into two groups：58 cases of transthoracic endoscopic thyroidectomy （laparoscopic group）and 72 cases of open surgery （open group）.To compare the difference of operative time,blood loss,postoperative hospital stay,postoperative drainage,drainage time,hospital costs,postoperative cosmetic results,postoperative complications,postoperative pain scores and patient satisfaction in two groups.Results In open group,hospital stay and incision length were significantly more /longer than those in laparoscopic group （P 〈0.05）,blood loss operative time,extubation time,hospital costs,drainage and postoperative pain VAS score were significantly less /shorter than laparoscopic group （P 〈0.05）.The two groups have no difference in the incidence of postoperative complications and recurrence rate.Patients are very beautiful and full-scale in laparoscopic group,extremely higher than the open group （P 〈0.05）.Conclusion Under strict control of its applicability,transthoracic approach endoscopic thyroidectomy should be worthy of recommendable surgery,which is better than open surgery.

关 键 词：甲状腺 腔镜 胸壁入路 

分 类 号：R653[医药卫生—外科学]