腔镜手术与开放手术治疗分化型甲状腺癌效果的对比分析  

Totally endoscopic vs open thyroidectomy for differentiated thyroid cancer

作　　者：曹一鸣[1] 庄亚强[1] 黄佳鹏[1] 周韬[1] 卿佳林 王丹英 Cao Yiming;Zhuang Yaqiang;Huang Jiapeng;Zhou Tao;Qing Jialin;Wang Danying(Department of Breast and Thyroid Surgery,Liuzhou People’s Hospital,Uuzhou 545006,China)

机构地区：[1]广西柳州市人民医院乳腺甲状腺外科,545006

出　　处：《中华普通外科杂志》2021年第6期421-425,共5页Chinese Journal of General Surgery

基　　金：广西卫生和计划生育委员会自筹经费科研课题(Z20170650)。

摘　　要：目的比较完全腔镜手术与开放手术治疗分化型甲状腺癌的临床效果。方法前瞻性分析2017年7月至2019年12月柳州市人民医院190例分化型甲状腺癌患者的临床资料,根据手术方式分为腔镜手术组和开放手术组各95例。结果腔镜手术组比开放手术组的手术时间、住院时间长[(153±25)min比(116±17)min、(5.56±1.08)d比(5.08±1.04)d,t=11.827.3.083,均P<0.05]。两组术中出血量差异无统计学意义[(33±14)ml比(37±16)ml,t=-1.851,P>0.05]。术后喉返神经麻痹.甲状旁腺功能低下、切口相关并发症的发生率差异均无统计学意义(4%比9%.9%比15%.1%比3%.均P>0.05)。腔镜手术组中央区淋巴结清扫数目(6.12±3.54)枚、开放组(6.35±4.75)枚,差异无统计学意义(t=0.404.P<0.05)。与开放手术组相比,腔镜手术组术后搬痕长度更小[(3.03±0.27)cm比(6.47±0.53)cm,t=56.138,P<0.05]。所有患者术后短期随访均未发现复发转移。结论腔镜手术与.开放手术相比治疗效果相当,但是有着更好的外观美容效果。Objective To compare toally endoscopic thyroidectomy(TET)with open thyroidectomy(OT)in the treatment of differentiated thyroid cancer.Methods Data of 190 patients at Liuzhou People's Hospital from Jul 2017 to Dec 2019 were analyzed.Patients were divided into endoscopic surgery group(n=95)and open surgery group(n=95).Results The operation time and the hospital stay in endoscopic group were longer than that in open surgery group[(153±25)min vs.(116±17)min,(5.56±1.08)d vs.(5.08±1.04)d,t=11.827,3.083,both P<0.05)].There was no significant difference in intraoperative blood loss[(33±14)ml us.(37±16)ml,t=-1.851 P>0.05],recurrent laryngeal nerve paralysis,hypoparathyroidism and wound complications(4%vs.9%,9%vs.15%,1%vs.3%,all P>0.05).There was no significant difference in the number of central lymph node dissection between the two groups(6.12±3.54 vs.6.35±4.75,t=-0.404,P<0.05).The length of scar in endoscopic group was shorter[(3.03±0.27)cm vs.(6.47±0.53)cm,t=_56.138,P<0.05),and the postoperative cosmetic score evaluated by the patients was higher(8.76±0.75 v/s.7.39±0.76,P<0.05),than those in open group.There were no tumor recurrence nor metastasis in neither group by short term follow-up.Conclusions TET is similar to OT on clinical curative effectiveness for differentiated thyroid carcinoma while carries a better cosmetic result.

关 键 词：甲状腺肿瘤 甲状腺切除术 淋巴结切除术 外科手术 微创性 

分 类 号：R73[医药卫生—肿瘤]