腋窝入路无充气完全腔镜下甲状腺癌根治术对颈部功能的影响  

Effect of complete endoscopic radical thyroidectomy via gasless axillary approach on the neck function

作　　者：那将超[1] 朱江[1] 狄长安[1] NA Jiang-chao;ZHU Jiang;DI Chang-an(Department of General Surgery,Beijing Pinggu Hospital,Beijing 101200,China)

机构地区：[1]北京市平谷区医院普外科,北京101200

出　　处：《局解手术学杂志》2023年第3期234-238,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：北京市平谷区医院青年人才项目(pgyyqn2020-03)。

摘　　要：目的探究腋窝入路无充气完全腔镜下甲状腺癌根治术对患者颈部功能的影响。方法选取北京市平谷区医院2020年5月至2021年5月行腋窝入路无充气完全腔镜下甲状腺癌根治术治疗的78例患者作为研究对象(腔镜组),另择同期行开放性甲状腺癌根治术治疗的63例患者作为对照(开放组),进行前瞻性临床对照研究。比较2组患者手术相关指标,比较2组患者术后3 d(T1)、6个月(T2)和12个月(T3)的视觉模拟量表(VAS)评分、颈部损伤指数和吞咽障碍指数。结果腔镜组的手术时间和术后引流量均长/多于开放组(P<0.001)。2组患者的VAS评分、颈部损伤指数和吞咽障碍指数均随时间进展呈降低趋势,2组患者T1、T2和T3时点的VAS评分和颈部损伤指数差异均无统计学意义(P>0.05),腔镜组T1、T2和T3时点的吞咽障碍指数均低于开放组(P<0.05)。腔镜组的吞咽障碍指数降低幅度小于开放组(OR=0.120,95%CI:0.070~0.207,P<0.001)。结论腋窝入路无充气完全腔镜下甲状腺癌根治术对患者颈部疼痛和颈部损伤的影响与开放性甲状腺癌根治术相当,但其对吞咽功能的影响更小。Objective To investigate the effect of complete endoscopic radical thyroidectomy via a gasless axillary approach on the neck function of patients.Methods A total of 78 patients received complete endoscopic radical thyroidectomy via a gasless axillary approach(the endoscopic group)from May 2020 to May 2021 in Beijing Pinggu Hospital were selected and 63 patients received open radical thyroidectomy(the open group)at the same time were selected as the control for prospective clinical control study.The related indexes of operation were compared between the two groups.The visual analogue scale(VAS)score,neck injury index and dysphagia handicap index 3 days(T1),6 months(T2)and 12 months(T3)after operation were compared between the two groups.Results The operation time and post-operative drainage volume in the endoscopic group were longer/higher than those in the open group(P<0.001).The VAS score,neck injury index and dysphagia handicap index of the two groups decreased with time,there was no significant difference in the VAS score or neck injury index at T1,T2 and T3 between the two groups(P>0.05),the dysphagia handicap indexes at T1,T2 and T3 of the endoscopic group were lower than those of the open group(P<0.05),and the decrease of dysphagia handicap indexes in the endoscopic group was smaller than that in the open group(OR=0.120,95%CI:0.070 to 0.207,P<0.001).Conclusion The effect of complete endoscopic radical thyroidectomy via a gasless axillary approach on neck pain and neck injury in patients is equivalent to the open radical thyroidectomy,but it has less effect on swallowing function.

关 键 词：甲状腺癌 腋窝入路 无充气 完全腔镜 根治术 颈部功能 

分 类 号：R736.1[医药卫生—肿瘤]