甲状腺系膜切除在经腋窝腔镜甲状腺乳头状癌手术中的应用效果评价  

Evaluation of the Effect of Mesorectal Excision in Transaxillary Endoscopic Thyroidectomy for Papillary Thyroid Carcinoma

作　　者：刘岩 高新宝[1] 王明玲[1] 李浩[1] 贾高磊[1] Liu Yan;Gao Xinbao;Wang Mingling(Department of Vascular Thyroid Hernia Minimally Invasive Surgery,Xuzhou Central Hospital,Xuzhou Clinical School of Xuzhou Medical University,Xuzhou 221009,China)

机构地区：[1]徐州市中心医院徐州医科大学徐州临床学院血甲疝微创外科,徐州221009

出　　处：《中国微创外科杂志》2024年第1期13-18,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：徐州市科技计划项目(KC22156);徐州医科大学附属医院科技发展面上项目(XYFM202204)。

摘　　要：目的探讨甲状腺系膜切除在无充气经腋窝入路腔镜甲状腺手术中的应用效果。方法回顾性分析2020年5月~2022年11月75例甲状腺乳头状癌行无充气经腋窝入路单侧甲状腺手术的临床资料。40例行甲状腺系膜切除(观察组),35例先切除甲状腺再清扫中央区淋巴结(对照组)。比较2组手术时间、术中出血量、术后住院时间、清扫淋巴结数目及术后并发症。结果手术均使用腔镜完成。与对照组相比,观察组手术时间短[(91.8±19.7)min vs.(110.4±19.3)min,t=-4.133,P=0.000],清扫淋巴结多[(6.5±2.5)枚vs.(4.6±2.0)枚,t=3.610,P=0.001],2组术中出血量、喉返神经损伤及术后住院时间差异无显著性,2组均无甲状旁腺功能减退及术后大出血、切口感染。结论甲状腺系膜切除在经腋窝入路腔镜甲状腺手术中安全可行,中央区淋巴结清扫数目较多,喉返神经保护较好。Objective To explore the therapeutic effect of mesorectal excision in gasless transaxillary endoscopic thyroidectomy.Methods Clinical data of 75 patients who underwent gasless unilateral transaxillary endoscopic thyroidectomy from May 2020 to November 2022 were retrospectively analyzed.A total of 40 cases were treated with mesorectal excision(observation group),and 35 cases were treated with thyroid resection followed with central lymph node resection(control group).The operation time,intraoperative blood loss,postoperative hospital stay,number of lymph nodes dissected,and postoperative complications were compared between the two groups.Results All the patients successfully completed the operation.As compared with the control group,the observation group had shorter operation time[(91.8±19.7)min vs.(110.4±19.3)min,t=-4.133,P=0.000]and more lymph nodes dissected[(6.5±2.5)vs.(4.6±2.0),t=3.610,P=0.001].There were no statistically significant differences between the two groups in the amount of intraoperative bleeding,recurrent laryngeal nerve injury,and the postoperative hospital stay.There was no hypoparathyroidism,postoperative bleeding,or wound infection in both groups.Conclusion Mesorectal excision is safe and feasible in endoscopic thyroidectomy via axillary approach,with more thorough lymph node dissection in the central region and better protection of recurrent laryngeal nerve.

关 键 词：内镜手术 系膜切除 腋窝 甲状腺 

分 类 号：R736.1[医药卫生—肿瘤]