cT1N0甲状腺癌全乳晕入路腔镜手术与开放手术对比研究  

Breast areolar approach in endoscopic surgery versus open surgery for thyroid cancer in cT1N0 stage

作　　者：赵宁[1] 滕长胜[1] 王旭东[1] 杨达明 王力 祁宇航 高天阔 刘宇萌[1] Zhao Ning;Teng Changsheng;Wang Xudong;Yang Daming;Wang Li;Qi Yuhang;Gao Tiankuo;Liu Yumeng(Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院普通外科,北京100050

出　　处：《中华内分泌外科杂志》2020年第1期18-22,共5页Chinese Journal of Endocrine Surgery

基　　金：首都医科大学本科生科研创新项目(XSKY2019163)。

摘　　要：目的探讨腔镜手术对甲状腺癌的治疗能否达到与开放手术同等的效果。方法选择2016年3月至2017年10月间首都医科大学附属北京友谊医院普通外科收治的、分期cT1N0、女性、年龄≤60岁、无颈部手术史、有美容愿望的患者44例进行全乳晕入路腔镜手术治疗。随机选择同等条件的50例开放手术作为对照。观察两组手术完成情况、并发症、淋巴结清扫率及住院时间等情况。结果手术时间腔镜手术组(170.0±28.0)min长于开放手术组(90.0±21.0)min(t=15.610,P=0.000)。术中出血量腔镜手术组(5.8±8.7)ml与开放手术组(4.8±5.6)ml差异无统计学意义(t=0.668,P=0.506)。喉返神经损伤腔镜手术组1/44例与开放手术组1/50例差异无统计学意义(χ^2=0.000,P=0.927)。甲状旁腺功能减退腔镜手术组7/44例与开放手术组4/50例差异无统计学意义(χ^2=1.417,P=0.234)。腔镜手术组与开放手术组均无淋巴漏、感染发生。清扫气管旁+气管前淋巴结数量腔镜手术组(6.0±4.2)枚与开放手术组(5.5±3.7)枚差异无统计学意义(t=0.692,P=0.491)。清扫喉前淋巴结数量腔镜手术组(0.7±1.1)枚与开放手术组(0.5±0.9)枚差异无统计学意义(t=1.186,P=0.239)。结论全乳晕入路腔镜手术治疗甲状腺癌安全可靠,颈中央区淋巴结清扫充分,可作为cT1N0甲状腺癌病例手术方式的选择。Objective To explore whether endoscopic surgery can achieve the same effect on thyroid cancer as open surgery.Method 44 cases were selected to endoscopic thyroidectomy with breast areola approach,who were prepared to accept the surgical treatment of thyroid cancer with cT1N0 stages,female,≤60 years old,no history of neck surgery and beauty desire.Fifty patients with the same conditions undergoing thyroid open surgery were as the control group.Results Operative time of endoscopic group[(170.0±28.0)min]was longer than that of the open operation group[(90.0±21.0)min(t=15.610,P=0.000)].There was no significant difference between the two groups in surgical complications(P>0.05).There was no statistical difference between the number of paratracheal and anterior tracheal lymph nodes of endoscopic group(6.0±4.2)and open surgery group(5.5±3.7)(t=0.692,P>0.05).There was no statistical difference between the number of anterior laryngeal lymph nodes of endoscopic group(0.7±1.1)and open surgery group(0.5±0.9)(t=1.186,P>0.05).Conclusion The breast areola approach endoscopic thyroidectomy is safe and reliable in treatment of thyroid cancer,and the central cervical lymph node dissection is sufficient,which can be used as the choice of operation mode for thyroid cancer patients in cT1N0 stage.

关 键 词：全乳晕入路 腔镜 甲状腺切除术 甲状腺癌 

分 类 号：R653[医药卫生—外科学] R736.1[医药卫生—临床医学]