不同手术入路腔镜甲状腺癌根治术的治疗效果  

Effect of endoscopic radical thyroidectomy via different surgical approaches on thyroid cancer

作　　者：周林荣[1] 陈宁[1] 黄森松 李豪健 杨开宇[1] ZHOU Lin-rong;CHEN Ning;HUANG Sen-song;LI Hao-jian;YANG Kai-yu(Department of Thyroid and Breast Surgery,Red Cross Hospital of Yulin City,Yulin 537000,Guangxi,China)

机构地区：[1]玉林市红十字会医院甲状腺乳腺外科,广西玉林537000

出　　处：《川北医学院学报》2024年第10期1370-1373,共4页Journal of North Sichuan Medical College

基　　金：广西壮族自治区玉林市科学研究与技术开发计划项目(202235075)。

摘　　要：目的:探讨经腋窝免充气(GUA)入路与经胸乳入路(BAET)腔镜甲状腺癌根治术的治疗效果。方法:选取150例腔镜下甲状腺癌根治术患者为研究对象,按照手术入路方式不同分为BAET组(经胸乳入路)及GUA组(经腋窝免充气入路),每组各75例。比较两组患者围术期相关指标[手术总时间、术中出血量、淋巴清扫数、总引流量、拔管时间及术后住院时间]、术后并发症发生情况、术后3 d疼痛情况[视觉模拟(VAS)评分]及术后3个月美观度[温哥华瘢痕量表(VSS)评分]。结果:相较于BAET组,GUA组患者手术总时间更长(P<0.05)、术中出血量更少(P<0.05)、总引流量更多(P<0.05)。两组患者术后总并发症发生率比较,差异无统计学意义(P>0.05)。术后3 d,GUA组患者VAS评分低于BAET组[(2.68±0.84)分vs.(3.16±0.98)分,P<0.05]。术后3个月,GUA组患者VSS总分及各维度评分均低于BAET组(P<0.05)。结论:GUA与BAET入路均对甲状腺癌根治术具有同等的有效性、安全性和可行性,虽然前者手术时间长、术后引流量多,但术后疼痛感更轻,具有更满意的美观度。Objective:To investigate the therapeutic effect of gasless unilateral axillary(GUA)approach and breast approach endoscopic thyroidectomy(BAET)endoscopic thyroidectomy for thyroid cancer.Methods:The clinical data of 150 patients with endoscopic radical thyroidectomy were retrospectively analyzed.According to the different surgical approaches,they were divided into BAET group(transthoracic breast approach)and GUA group(axillary non-inflatable approach),with 75 cases in each group.The perioperative related indexes(total operation time,intraoperative blood loss,number of lymph node dissection,total drainage volume,extubation time and postoperative hospital stay),postoperative complications,pain at 3 days after operation[visual analogue scale(VAS)]and aesthetics at 3 months after operation[Vancouver scar scale(VSS)]were compared between the two groups.Results:Compared with BAET group,the total operation time of GUA group was longer(P<0.05),the intraoperative blood loss was less(P<0.05),and the total drainage volume was more(P<0.05).There was no significant difference in the incidence of total complications between the two groups(P>0.05).At 3 days after operation,the VAS score of the GUA group was(2.68±0.84)points,which was lower than that of the BAET group(3.16±0.98)points(P<0.05).The total score of VSS and the scores of each dimension in GUA group were lower than those in BAET group(P<0.05).Conclusion:Endoscopic thyroidectomy via GUA approach for patients with thyroid cancer can achieve the same clinical effect as that via BAET approach.Although the total operation time of GUA approach is longer and the postoperative drainage volume is more,the pain is lighter and the cosmetic effect is better.

关 键 词：甲状腺癌 腔镜 经胸乳入路 经腋窝免充气入路 疗效 美观度 

分 类 号：R736.1[医药卫生—肿瘤]