腋窝与锁骨下入路腔镜甲状腺切除术对比研究  

A comparative study of axillary approach and subclavian approach endoscopic thyroidectomy

作　　者：刘念 李荣国 杜琪威 王自强 LIU Nian;LI Rongguo;DU Qiwei(The First People's Hospital of Xiaoshan District,Hangzhou,Zhejiang 311200,China)

机构地区：[1]浙江省杭州市萧山区第一人民医院,杭州311200

出　　处：《浙江创伤外科》2024年第8期1426-1428,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的 分析比较腋窝入路腔镜甲状腺切除术与锁骨下入路腔镜甲状腺切除术临床疗效。方法 回顾性分析2021年3月至2023年11月本院甲状腺外科病区收治的行腔镜腋窝入路或锁骨下入路的单侧甲状腺肿瘤切除患者临床资料。其中18例行腋窝入路腔镜甲状腺切除术患者归为A组,35例行锁骨下入路腔镜甲状腺切除术患者归为B组,比较两组手术耗时、术中出血情况、术后引流管引流天数、术后住院天数、手术并发症以及住院总支出等。探讨两种手术方式的临床实用性及优缺点。结果 两组比较其手术耗时、术中出血情况、术后引流管引流天数、术后住院天数、住院总支出均差异均有统计学意义(P<0.05),并发症差异无统计学意义(P>0.05)。结论 腋窝入路与锁骨下入路腔镜甲状腺手术相比,锁骨下入路的手术耗时更短,术中出血更少,术后引流管引流天数及术后住院天数更少,住院总支出更少,两者均具有较好的手术安全性,但腋窝入路切口隐蔽性更好。临床手术方式可结合患者意愿并权衡利弊选择。Objective To analyze and compare the clinical effects of endoscopic thyroidectomy via the axillary approach and subclavian approach.Methods The clinical data of patients(March 2021 to November 2023)undergoing unilateral thyroidectomy via endoscopic axillary or subclavian approaches in our thyroid surgery unit were analyzed retrospectively.Among them,18 patients with axillary approach were assigned to group A and 35 patients with subclavian approach were assigned to group B.The operation time,intraoperative bleeding,postoperative drainage time,postoperative hospitalization days,surgical complications,and hospital cost were compared.Results There were significant differences in operative time,Intraoperative bleeding,postoperative drainage time,postoperative hospitalization time,and hospital cost between the two groups(P<0.05).There was no significant difference in the occurrence of surgical complications(P>0.05).Conclusion Compared with the axillary approach endoscopic thyroid surgery,the subclavian approach has a shorter operative time,less intraoperative bleeding,shorter postoperative drainage time and hospital stay,and lower hospital costs,both of them have the same surgical safety,but the concealment of axillary approach incision is better.The surgical method can be chosen with the patient's preferences,the benefits and drawbacks of each option should be evaluated.

关 键 词：腔镜甲状腺切除术 腋窝 锁骨下 

分 类 号：R736.1[医药卫生—肿瘤]