经口腔前庭入路腔镜甲状腺切除术治疗无淋巴结转移甲状腺乳头状癌的效果观察  

Effect Observation of Transoral Endoscopic Thyroidectomy via Vestibular Approach in Treatment of Clinically Node Negative Papillary Thyroid Carcinoma

作　　者：黄林[1] 劳景茂[1] 刘广 邓伟[1] 韦小波[1] 简文红 Huang Lin;Lao Jingmao;Liu Guang;Deng Wei;Wei Xiaobo;Jian Wenhong(Department of Breast and Thyroid Surgery,The First People's Hospital of Qinzhou,Qinzhou 535000,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]钦州市第一人民医院甲乳外科,广西钦州535000

出　　处：《中国社区医师》2023年第14期16-18,共3页Chinese Community Doctors

基　　金：广西壮族自治区卫计委自筹经费科研课题(编号:Z20201008);广西壮族自治区临床重点专科建设项目经费资助(桂卫医发[2022]17号)。

摘　　要：目的:探讨经口腔前庭入路腔镜甲状腺切除术(TOETVA)治疗无淋巴结转移(cN0)甲状腺乳头状癌(PTC)的效果。方法:回顾性分析2018年1月—2020年10月钦州市第一人民医院收治的106例cN0 PTC患者的临床资料,根据治疗方式的不同分为观察组和对照组,各53例。对照组实施常规甲状腺开放手术,观察组实施TOETVA,比较两组手术效果、并发症发生情况及随访情况。结果:两组喉返神经信号消失比例、中央区淋巴结清扫数目、淋巴结转移阳性率、阳性淋巴结数目、引流量、拔管时间、住院时间比较,差异无统计学意义(P>0.05);观察组手术时间长于对照组,视觉模拟评分法评分低于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。术后6个月随访,两组均未见种植、复发、转移。结论:TOETVA治疗cN0 PTC的有效性及安全性与开放性手术相似,且可减少患者疼痛程度,值得临床推广。Objective:To investigate the effect of transoral endoscopic thyroidectomy via vestibular approach(TOETVA)in the treatment of clinically node-negative(cN0)papillary thyroid carcinoma(PTC).Methods:The clinical data of 106 patients with cN0 PTC treated in the First People's Hospital of Qinzhou from January 2018 to October 2020 were retrospectively analyzed.They were divided into the observation group and the control group according to the difference of treatment method,with 53 cases in each group.The control group implemented routine open thyroid surgery and the observation group implemented TOETVA.The surgical effect,complication and follow-up in the two groups were compared.Results:There were no significant differences in the proportion of recurrent laryngeal nerve signal loss,the number of central lymph node dissection,the positive rate of lymph node metastasis,the number of positive lymph nodes,the drainage,the extubation time and the length of hospital stay between the two groups(P>0.05).The operation time in the observation group was longer than that in the control group,and the visual analogue scale score in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).After postoperative 6-month follow-ups,no implantation,recurrence,or metastasis were seen in either group.Conclusion:TOETVA has the same effectiveness and safety as open surgery in the treatment of cN0 PTC,moreover it can reduce pain level of patients and deserves clinical promotion.

关 键 词：经口腔前庭入路腔镜甲状腺切除术 无淋巴结转移 甲状腺乳头状癌 

分 类 号：R736.1[医药卫生—肿瘤]