经口、经全乳晕、经腋下入路腔镜下单侧甲状腺癌根治术的疗效比较  

Comparasion of the efficacy of unilateral radical thyroidectomy via transoral,transareolar,and transaxillary approaches

作　　者：宋鹏飞 白宾[1] 赵永强 高延鑫 秦双[1] 薛会朝[1] Song Pengfei;Bai Bin;Zhao Yongqiang;Gao Yanxin;Qin Shuang;Xue Huichao(Department of Nail and Breast Surgery,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院甲乳外科,河南新乡453100

出　　处：《临床医学》2025年第1期16-19,共4页Clinical Medicine

摘　　要：目的比较经口腔前庭入路、经全乳晕入路、经腋窝入路腔镜下单侧甲状腺癌根治术的疗效以及并发症。方法回顾性分析2021年6月至2023年6月新乡医学院第一附属医院行腔镜下单侧甲状腺癌根治术治疗的134例中年患者的临床资料,根据手术方式分为经口组(n=46)、经全乳晕组(n=48)与经腋窝组(n=40)。经口组采用经口腔前庭入路,经全乳晕组采用经全乳晕入路,经腋窝组采用经腋窝入路。比较三组临床疗效、手术指标(手术时间、术中出血量、淋巴结清扫数量、术后引流量、住院时间)、手术满意度、术后瘢痕评分[温哥华瘢痕评价量表评分(VSS)、观测者瘢痕评价量表评分(OSAS)、患者瘢痕评价量表评分(PSAS)]及不良反应。结果术后6个月三组患者均无肿瘤未切除干净、复发或转移。三组术中出血量、淋巴结清扫数量、住院时间比较,差异未见统计学意义(P>0.05)。三组手术时间比较,差异有统计学意义(P<0.05)。经口组术后引流量低于经全乳晕组,差异有统计学意义(P<0.05)。经口组手术满意度评分优于经腋窝组、经全乳晕组,差异有统计学意义(P<0.05)。经口组VSS、OSAS、PSAS均低于经全乳晕组与经腋窝组,差异有统计学意义(P<0.05)。三组不良反应发生率比较,差异未见统计学意义(P>0.05)。结论与经全乳晕入路、经腋窝入路比较,经口腔前庭入路腔镜下甲状腺癌根治术具有更好的治疗效果和美观性,患者满意度和接受度较高。Objective To study the efficacy and complications of endoscopic unilateral radical resection of thyroid cancer through the transoral vestibular approach,the transareolar approach,and the transaxillary approach.Methods The clinical data of 134 middle-aged patients who underwent endoscopic radical surgery for unilateral thyroid cancer in the First Affiliated Hospital of Xinxiang Medical College from June 2021 to June 2023 were retrospectively analyzed,and they were divided into transoral group(n=46),transareolar group(n=48)and transaxillary group(n=40)according to the surgical method.Transvestibular approach was adopted in the transoral group,transareolar approach was adopted in the transareolar group and transaxillary approach was adopted in the transaxillary group.The clinical efficacy,surgical indexes(operation time,intraoperative blood loss,number of lymph node dissection,postoperative drainage volume,length of hospital stay),surgical satisfaction,postoperative scar[vancouver scar evaluation scale score(VSS),observer scar evaluation scale score(OSAS),patient scar evaluation scale score(PSAS)]and adverse reactions of the three groups were compared.Results Six months after operation,no tumor was resected,recurrent or metastatic in all of the three groups.There was no significant difference in the amount of blood loss,the number of lymph node dissection and the length of hospital stay among the three groups(P>0.05).The operation time of the three groups was compared,the difference was significant(P<0.05).The postoperative drainage volume of the transoral group was lower than that of the transareolar group,and the difference was significant(P<0.05).The surgical satisfaction score of transoral group was better than that of the transaxillary group and the transareolar group,and the differences were significant(P<0.05).The VSS,OSAS and PSAS of the transoral group were lower than those of the transareolar group and the transaxillary group,and the differences were significant(P<0.05).There was no significant difference

关 键 词：经口腔前庭入路 经全乳晕入路 经腋窝入路 甲状腺肿瘤 疗效 

分 类 号：R73[医药卫生—肿瘤]