双孔与单孔免充气经腋窝入路腔镜甲状腺手术的应用对比  

Comparison of the clinical application of double-port and single-port gasless transaxillary endoscopic thyroidectomy

作　　者：张浩[1] 陈延松[1] 张晓静[1] 唐经纬 李成伟 金功圣[1] ZHANG Hao;CHEN Yan-song;ZHANG Xiao-jing(Department of Surgical Oncology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院肿瘤外科,安徽蚌埠233000

出　　处：《腹腔镜外科杂志》2020年第9期669-672,682,共5页Journal of Laparoscopic Surgery

摘　　要：目的:对比分析双孔与单孔免充气经腋窝入路腔镜甲状腺手术的临床效果。方法:选择2018年10月至2019年10月手术治疗的46例甲状腺乳头状癌患者,其中双孔组24例,单孔组22例。两组均采用自制免充气建腔器械行免充气经腋窝入路腔镜甲状腺切除术。比较两组患者一般资料、手术情况及术后满意度等相关指标。结果:46例手术均顺利完成。双孔组手术时间、切口长度短于单孔组,差异有统计学意义(P<0.05);两组术中出血量、术后24 h引流量、住院时间、中央区淋巴结清扫数量、术后第1天疼痛评分及美容效果评分差异无统计学意义(P>0.05)。术后双孔组出现皮下积液2例、颈部不适1例,单孔组发生皮下积液2例、饮水呛咳1例、一过性声带麻痹2例;两组术后并发症发生率差异无统计学意义(P>0.05)。结论:双孔与单孔免充气经腋窝入路腔镜甲状腺切除术均是安全、可行的;而双孔法更方便操作,利于术后恢复,适合在临床中应用。Objective:To compare the clinical effects of double-port and single-port gasless transaxillary endoscopic thyroidectomy.Methods:Forty-six patients with thyroid papillary carcinoma from Oct.2018 to Oct.2019 were selected,the double-port group included 24 patients and the single-port group consisted of 22 patients.Both groups adopted the self-made gasless cavity construction equipment to perform gasless transaxillary endoscopic thyroidectomy.The general information,surgical condition and postoperative satisfaction of the two groups were compared.Results:All operations were successfully completed.By comparison of the two groups,the operation time and incision length of the double-port group were lower than these of the single-port group,with statistically significant differences(P<0.05);While the intraoperative blood loss,drainage volume of 24 h after surgery,hospital stay,number of central lymph node dissection,pain score on the first day after surgery and cosmetic effect numerical score showed no statistically significant difference(P>0.05).Postoperative complications occurred in the two groups,including 2 cases of subcutaneous effusion and 1 case of neck discomfort in the double-port group;and 2 cases of subcutaneous effusion,1 case of drinking choke and 2 cases of transient vocal cord paralysis in the single-port group.The incidence of postoperative complications were not statistically significantly different between the two groups(P>0.05).Conclusions:Both double-port and single-port gasless transaxillary endoscopic thyroidectomy are safe and feasible.While the double-port method is more convenient to operate,more conducive for recovery,and more suitable for clinical application.

关 键 词：甲状腺切除术 内窥镜检查 双孔 单孔 免充气 经腋窝入路 

分 类 号：R653[医药卫生—外科学]