摘要
目的探讨针式辅助技术在全腔镜胸乳入路甲状腺癌手术中的应用，评价针式辅助技术对全腔镜甲状腺癌手术的影响。方法前瞻性选择2014年1月至12月于福建医科大学附属协和医院甲状腺外科接受腔镜单侧甲状腺手术的145例甲状腺乳头状癌患者，随机分为常规腔镜组（64例）及针式辅助组（81例）。人组患者男性11例，女性134例；年龄12～54岁，平均年龄36岁。两组均接受单侧甲状腺腺叶切除及中央区淋巴结清扫，针式辅助组采用MiniLap辅助进行手术。采用两独立样本的t检验和χ2检验比较两组的术中情况、术后效果和并发症。结果常规腔镜组和针式辅助组的腺叶切除时间分别为（42±7）min和（31±7）min（t=9．082，P=0．000），中央区淋巴结清扫时间分别为（33±6）min和（26±3）min（t=9．050，P=0．000），术后一过性喉返神经麻痹例数分别为4例和0例（χ2=5．206，P=0．036）。在其他并发症及术后美容效果方面，差异无统计学意义。结论全腔镜胸乳入路甲状腺癌手术及针式辅助的全腔镜甲状腺癌手术均为安全可靠的手术方式，具有较高的美容效果。针式辅助器械的应用可以缩短手术时间，降低一过性喉返神经麻痹的发生。
Objective To study application of needlescopic assisted hemithyroidectomy and central neck dissection using bilateral breast approach. Methods Totally 145 cases of papillary thyroid cancer patients received endoscopic hemithyroidectomy in Fujian Medical University Union Hospital were randomized to needle assisted endoscopic group （ NE group, n = 81 ） and conventional endoscopic group （ CE group, n = 64 ）. The average age of the patients was 35.9 years and 11 patients were male. All patients undeiwent hemithyroidectomy and central neck dissection through bilateral breast approach, the NE group additional used the MiniLap-assisted intraoperation. The operative time, postoperative complications and cosmetic results were analyzed by t-test and χ2 test. Results The operation time of thyroid gland in NE and CE Group was （42 ±7） min and （31 ±7） min（t =9. 082, P =0. 000） ,respectively. The operation time of central neck dissection was （33 ± 6 ） min and （ 26 ± 3 ） min （ t = 9. 050, P = 0. 000）, respectively. There were 4 cases occurs transient recurrent laryngeal nerve paralysis in CE group and no case occur in NE group （ χ2 = 5. 206, P = 0. 036 ）. There was no significant different in other postoperative complications and cosmetic results. Conclusions Hemithyroidectomy and central neck dissection using bilateral breast approach and needlescopic assisted technique isa safe and reliable approach, with high cosmetic effect. Application needle assistive devices can shorten the operation time while no significant increase trauma in patients, it will makes endoscopic thyroid surgery easier to promote.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2016年第1期44-48,共5页
Chinese Journal of Surgery
基金
福建省中青年卫生骨干人才科研项目（2013-ZQN-ZD-13）
福建省卫生计生委青年科研课题（2015-1-43）
国家卫生部临床重点专科建设项目
福建省临床重点专科建设项目
关键词
甲状腺肿瘤
内窥镜检查
针式辅助技术
Thyroid neoplasms
Endoscopy
Needlescopic assisted technique
