Miccoli术式在颈侧区淋巴结清扫的价值及近期疗效评估  

The valuee and short-term efficacy of Miccoli for cervical lymph node dissection

作　　者：王崇高 韩玮 鲁凯 崔梦迪 姜孝燕 Wang Chonggao;Han Wei;Lu Kai;Cui Mengdi;Jiang Xiaoyan(Department of Thyriod and Breast Surgery, Nanjing Hospital of Nanjing University of Chinese Medicine (Nanjing Chinese Traditional Medicine Hospital), Nanjing 21000, China)

机构地区：[1]南京中医药大学附属南京中医院甲乳外科,210001

出　　处：《中华内分泌外科杂志》2019年第5期423-428,共6页Chinese Journal of Endocrine Surgery

摘　　要：目的评价Miccoli术式对甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者颈侧区淋巴结清扫术的价值及近期疗效。方法对2017年3月至2018年1月在南京中医药大学附属南京中医院甲乳外科行颈侧区淋巴结清扫术15例,根据随机对照原则分为开放术式8例和Miccoli术式7例,分析两组在手术时间、切口长度、术中出血量、清扫淋巴结总数、术后并发症发生率及住院时间的差别,术后随访6个月分析两组在颈部舒适度、颈侧区肿大淋巴结发生率及血甲状腺球蛋白水平的差异。结果两组患者在术中出血量(P=0.651)、清扫淋巴结总数(P=0.887)、术后并发症发生率(P=0.520)、术后6个月患者的颈侧区肿大淋巴结发生率(P=1.000)及血甲状腺球蛋白水平(P=0.826)无明显差异,Miccoli组的手术时间长于开放组(P=0.001),但切口长度(P=0.001)、住院时间(P=0.001)及术后颈部舒适度(P=0.001)明显优于开放手术组。结论PTC患者采用Miccoli术式行颈侧区淋巴结清扫可达到开放手术的清扫效果,不增加术后并发症的风险且术后患者颈部舒适度较好。Objective To evaluate the value and short-term efficacy of Miccoli for cervical lymph node dissection in patients with thyroid papillary carcinoma. Methods From Mar. 2017 to Jan. 2018, 15 patients with thyroid papillary carcinoma received cervical lymph node dissection in Department of Thyroid and Breast Surgery of Nanjing Chinese Traditional Medicine Hospital, and they were divided into open surgery group (8 cases) and Miccoli surgery group (7 cases). The operation time, incision length, intraoperative blood loss, total number of dissection lymph nodes, incidence of postoperative complications and length of hospital stay between the two groups were analyzed. These groups were followed up for 6 months after surgery, in terms of neck comfort, incidence of enlarged lymph nodes in the cervical region and blood thyroglobulin level. Results There was no obvious difference between the two groups in intraoperative blood loss (P=0.651), total number of dissection lymph nodes (P=0.887), the incidence of postoperative complications (P=0.52), incidence of intumescent lymph node (P=1.000) and blood thyroglobulin level (P=0.826) after 6 months. The operation time of Miccoli group was longer than that of the open group (P=0.001), but the incision length (P=0.001), length of hospital stay (P=0.001) and postoperative neck comfort (P=0.001) were superior to those of the open surgery group. Conclusion Miccoli operation can be used to perform cervical lymph node dissection for PTC patients, which can achieve the curative effect of open surgery, without increasing the risk of postoperative complications, and the postoperative neck comfort was better.

关 键 词：Miccoli术 甲状腺乳头状癌 颈淋巴结清扫术 

分 类 号：R73[医药卫生—肿瘤]