经锁骨下切口无充气腔镜双侧甲状腺切除术的疗效和安全性  

Analysis of the efficacy and safety of endoscopic bilateral thyroidectomy using the gasless subclavian approach

作　　者：王岩岩[1] 黄建康[1] 张超[1] 彭德峰[1] 陈春春[1] 董慧明[1] 李玉龙 王苏杭 金国玺[1] WANG Yanyan;HUANG Jiankang;ZHANG Chao;PENG Defeng;CHEN Chunchun;DONG Huiming;LI Yulong;WANG Suhang;JIN Guoxi(Department of Thyroid and Breast Surgery,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甲乳外科,安徽蚌埠233000

出　　处：《实用医学杂志》2021年第8期1026-1030,共5页The Journal of Practical Medicine

基　　金：安徽省教育厅自然科学研究重大项目(编号:KJ2019ZD29);蚌埠市科技创新指导类项目(编号:20200350)。

摘　　要：目的探讨经锁骨下切口无充气腔镜双侧甲状腺切除术的疗效和安全性。方法回顾性分析蚌埠医学院第一附属医院甲乳外科2019年10月至2020年9月行双侧甲状腺手术治疗的39例患者,其中19例行锁骨下切口入路腔镜手术,20例行传统开放手术。比较两组手术总时间、术中出血量、恶性患者中央区淋巴结清扫数、术后疼痛视觉模拟量表(VAS)、术后住院时间、术后并发症和术后3个月美容满意度的差异。结果腔镜组平均手术时间长于传统开放组(P <0.05),术后3 d疼痛评分高于传统开放组(P <0.05),术后美容满意度明显高于传统开放组(P <0.05)。两组患者术中出血量、术后住院时间、恶性患者中央区淋巴结清扫数目、术后并发症及术后3个月疼痛评分的差异无统计学意义(均P> 0.05)。结论经锁骨下切口腔镜甲状腺手术适用于有美容需求且需行双侧甲状腺切除的患者,术后患者切口美容满意度高。Objective To investigate the efficacy and safety of endoscopic bilateral thyroidectomy using the gasless subclavian approach space.Methods Retrospective analysis of 39 patients who underwent bilateral thyroid surgery in the First Affiliated Hospital of Bengbu Medical College from October 2019 to September 2020 was performed,including 19 cases of subclavian incision and 20 cases of traditional open surgery.Analysis of the differences in total operative time,estimated intraoperative blood loss,central lymph node dissection in malignant patients,postoperative pain visual analogue scale(VAS),postoperative hospitalization time,postoperative complications,and cosmetic satisfaction at 3 months after surgery.Results The average operation time of the endoscopic group was longer 1than that of the traditional open group(P<0.05),the pain score 3 days after operation was higher than that of the traditional open group(P<0.05),and the postoperative cosmetic satisfaction was significantly higher than that of the traditional open group(P<0.05).There was no significant difference in intraoperative blood loss,postoperative hospital stay,number of central lymph node dissection,postoperative complications and pain score 3 months after operation between the two groups(all P>0.05).Conclusion Endoscopic bilateral thyroidectomy using the gasless subclavian approach is suitable for patients with high cosmetic requirements,and patients′satisfaction with incision cosmetic is high.

关 键 词：双侧甲状腺切除术 无充气 腔镜 锁骨下入路 疗效及安全性 

分 类 号：R736.1[医药卫生—肿瘤]