腋窝入路免充气腔镜与开放甲状腺手术的对比研究  

Comparative study of gasless transaxillary endoscopic thyroidectomy and open thyroidectomy

作　　者：代英曼 陈波[1] 李鲁传[1] 张温花[1] 曾庆东[1] DAI Ying-man;CHEN Bo;LI Lu-chuan(Department of General Surgery,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院普通外科,山东济南250012

出　　处：《腹腔镜外科杂志》2022年第7期487-490,共4页Journal of Laparoscopic Surgery

摘　　要：目的:对比经腋窝入路免充气腔镜与传统开放甲状腺手术治疗单侧甲状腺乳头状癌的临床效果及术后并发症。方法:选取2021年1月至2021年12月接受腋窝入路免充气腔镜甲状腺手术的51例单侧甲状腺乳头状癌患者(腋窝组),采用倾向性评分匹配的方法校正年龄、性别、体重指数、肿瘤大小、多灶性等一般资料,以1∶1比例匹配同时期接受传统手术的51例单侧甲状腺乳头状癌患者(开放组)。对比分析两组中央区淋巴结清扫效果及术后并发症等。结果:腋窝组与开放组中央区淋巴结清扫数量[(4.6±2.3)vs.(4.8±3.0),P=0.687]、清扫中央区淋巴结阳性比例[33.3%(17/51)vs.31.4%(16/51),P=0.832]差异无统计学意义。腋窝组手术时间长于开放组,两组术中出血量、术后住院时间差异无统计学意义。两组脉管内癌栓、侵犯被膜、腺内播散、合并桥本甲状腺炎、合并结节性甲状腺肿等差异均无统计学意义(P>0.05)。两组术后饮水呛咳、一过性声音嘶哑、血清肿、血肿等并发症发生率差异亦无统计学意义(P>0.05)。结论:经腋窝入路行免充气腔镜甲状腺手术治疗单侧甲状腺乳头状癌根治效果确切,与传统开放手术效果相当,同时并不增加术后早期并发症。Objective:To compare the clinical effect and postoperative complications of gasless endoscopic thyroidectomy through axillary approach and traditional open surgery for treating unilateral papillary thyroid carcinoma.Methods:A total of 51 patients with unilateral papillary thyroid carcinoma who underwent gasless endoscopic thyroidectomy in the axillary approach from Jan.2021 to Dec.2021 were selected(axillary group).51 patients of unilateral papillary thyroid carcinoma who received open thyroidectomy(open group)during the same period were matched using propensity score matching in a 1∶1 ratio by adjusting age,gender,body mass index,tumor size and multifocality.Central lymph node dissection,postoperative complications and so on were compared between the two groups.Results:There was no significant difference in the number of central lymph nodes dissected[(4.6±2.3)vs.(4.8±3.0),P=0.687]and the proportion of positive central lymph nodes[33.3%(17/51)vs.31.4%(16/51),P=0.832]between the axillary group and the open group.The operation time of the axillary group was significantly longer than that of the open group,there was no difference between the two groups in the amount of intraoperative blood loss,postoperative hospital stay,lymphovascular invasion,capsule invasion,intraglandular spread,the coexistence of Hashimoto's thyroiditis background and nodular goiter,and the incidence of postoperative complications such as choking when drinking water,transient hoarseness,seroma and hematoma(P>0.05).Conclusions:The gasless endoscopic thyroidectomy through the axillary approach displays similar oncological effect with the traditional open surgery for treating unilateral papillary thyroid carcinoma,meanwhile,does not increase the early postoperative complications.

关 键 词：甲状腺肿瘤 内窥镜检查 经腋窝入路 免充气 对比研究 

分 类 号：R653[医药卫生—外科学]