不同入路腔镜甲状腺手术和传统开放甲状腺手术疗效分析  

Comparison of conventional transcervical thyroidectomy and endoscopic thyroidectomy through three different approaches

作　　者：来益 沈宇玲[1] 王家东[1] LAI Yi;SHEN Yuling;WANG Jiadong(Department of Head and Neck Surgery,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China)

机构地区：[1]上海交通大学医学院附属仁济医院头颈外科,上海200001

出　　处：《中国眼耳鼻喉科杂志》2023年第1期34-38,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的 通过对不同入路腔镜甲状腺手术和传统开放甲状腺手术的比较,分析不同手术入路的优势及不足。方法 回顾分析2019年1月~2021年1月本院行腔镜下经口、经全乳晕、经腋下入路及传统开放甲状腺癌根治术的患者基本情况、手术情况及术后随访资料。结果 3种入路腔镜组患者平均年龄均小于传统组,淋巴结阳性率和转移比例差异无统计学意义。3种入路腔镜组手术时间均较传统组长,但各腔镜组间差异无统计学意义;腔镜入路住院时间及引流管放置时间均较传统组长,但各腔镜组间差异无明显统计学意义。经口组术后第1天疼痛最为明显,术后1个月疼痛改善明显,4种手术入路1个月后疼痛无明显差异。术后切口满意度以经口组最高,经腋组次之,全乳晕组和传统组无明显差异。结论 腔镜下甲状腺癌根治术的疗效优于传统开放手术,虽然延长了患者住院时间,增加了住院费用,但患者术后切口满意度较高,有助于提高患者术后生活质量。Objective To analyze the advantages and disadvantages of endoscopic thyroidectomy through different approaches compared with conventional transcervical thyroidectomy. Methods Between January 2019 and January 2021, 100 patients underwent thyriodectomy through different approaches for thyroid cancer in our department. The medical records of these patients were reviewed retrospectively, and the surgical complications were assessed on the basis of clinical findings. Pain score and cosmetic satisfaction was evaluated in questionnaires at first day and 1month, 6 months after surgery respectively. Results Patients of endoscopic groups were younger than the traditional group, while the lymph node positive rate and metastasis ratio of the endoscopic groups were same with the traditional group. The operating time of the endoscopic groups was longer than that of the traditional group. The hospitalization time and drainage placement time was longer in endoscopic groups compared with the traditional group. Pain was most obvious at the first day in the transoral group, and relieved significantly one month postoperatively. Cosmetic satisfaction was the highest in the transoral group, followed by the transaxillary group. Conclusions Endoscopic thyroidectomy had good surgical effect compared with conventional transcervical thyroidectomy. Although endoscopic surgery extends hospitalization time and increases hospitalization costs, cosmetic satisfaction after surgery was high, which could further improve the patients’ quality of life.

关 键 词：甲状腺癌 腔镜甲状腺手术 经口入路 腋窝入路 全乳晕入路 

分 类 号：R736.1[医药卫生—肿瘤]