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作 者:于彬 姜立新[1,2] 王东 崔希刚[1] 宁进尧 李苗苗[1] 李宝元[1] YU Bin;JIANG Li-xin;WANG Dong(Department of Gastrointestinal Surgery and Thyroid Surgery,Yantai Yuhuangding Hospital Affiliated to Qingdao University,Yantai 264000,China;Department of General Surgery,Yantai Yeda Hospital)
机构地区:[1]青岛大学附属烟台毓璜顶医院胃肠外一科甲状腺外科,山东烟台264000 [2]烟台业达医院普通外科
出 处:《腹腔镜外科杂志》2023年第3期176-180,共5页Journal of Laparoscopic Surgery
基 金:山东省老年医学学会科技攻关计划(LKJGG2021Y048);烟台市科技创新发展计划(2022YD032)。
摘 要:目的:对比分析腔镜辅助与开放功能性颈淋巴结清扫术治疗甲状腺乳头状癌伴颈侧淋巴结转移的彻底性、安全性及美容效果。方法:回顾分析2019年1月1日至2021年6月30日收治的216例甲状腺乳头状癌伴颈侧淋巴结转移患者的临床资料,均行甲状腺全切、双侧中央区及单侧功能性颈淋巴结清扫术,根据术式分为腔镜组(n=101)与开放组(n=115),对比分析两组临床病理特征、围手术期相关情况及美容微创满意程度。结果:两组患者性别、年龄、清扫侧别、肿瘤最大径、手术时间、术后住院时间、清扫淋巴结数量、转移淋巴结转数量及术后并发症发生率差异均无统计学意义(P>0.05);腔镜组在手术切口长度、术中出血量、术后疼痛评分、颈部感觉异常与美容满意程度等方面优于开放组(P<0.05)。结论:在不影响手术安全性、彻底性的前提下,腔镜辅助手术较开放手术美容效果更佳。Objective:To compare the thoroughness,safety and cosmetic feature of endoscopic-assisted and open functional neck dissection in the treatment of thyroid papillary carcinoma with lateral cervical lymph node metastasis.Methods:The clinical data of patients with thyroid papillary carcinoma with lateral cervical lymph node metastasis from Jan.1,2019 to Jun.30,2021 were retrospectively analyzed,the patients underwent total thyroidectomy,bilateral central and unilateral functional neck dissection,and finally 216 patients were included in the endoscopic group(n=101)and open group(n=115).The clinicopathological features,perioperative relevant information and cosmetic minimally invasive satisfaction were compared between the two groups.Results:There was no significant difference in gender,age,dissection side,maximum diameter of tumor,duration of surgery,postoperative hospital stay,number of lymph node dissection,number of metastatic lymph nodes and incidence of postoperative complications between the two groups(P>0.05).The length of incision,intraoperative blood loss,postoperative pain score,abnormal sensation of neck and cosmetic satisfaction in the endoscopic group were significantly better than those in the open group(P<0.05).Conclusions:Without sacrificing the safety and thoroughness of the operation,the cosmetic effect of endoscopic-assisted surgery is better than that of open surgery,and endoscopicassisted surgery is worthy of wide clinical application.
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