摘要
目的:探究右侧腋窝-双侧乳晕入路达芬奇机器人甲状腺切除术的安全性及短期疗效。方法:回顾性分析2018年1月至2021年6月就诊于中国人民解放军联勤保障部队第九四〇医院普通外科并确诊为甲状腺癌行甲状腺切除术的185例患者。其中行达芬奇机器人辅助手术(机器人组)的患者87例,行传统开放手术(传统手术组)的患者98例,随访资料截取至术后3月。比较两组患者的手术时间、术中出血量、术中神经损伤率、术中甲状旁腺损伤率、中央区淋巴结清扫情况、引流天数、引流液总量、切口并发症发生率、术后疼痛评分、术后3月术区感觉、术后3月美容评分等指标。结果:两组患者在肿瘤位置、肿瘤直径、性别、体重指数、中央区淋巴结清扫情况、引流天数、引流液总量、神经损伤率、切口并发症发生率以及术后72 h疼痛评分上差异无统计学意义(P>0.05),机器人组较传统手术组在年龄[(38.60±10.00) vs (45.95±10.79)岁]、手术时间[(178.80±43.58) vs (136.19±43.22)min]、术中出血量[(27.01±21.81) vs (36.84±30.31)mL]、甲状旁腺损伤率(26.44%vs 42.86%)、术后24 h疼痛评分[(3.33±0.58) vs (4.47±0.68)分]、术后48 h疼痛评分[(1.62±0.58) vs (2.19±0.73)分]、术后3月颈部感觉异常率(3.45%vs 11.22%)、术后3月美容评分[(8.60±1.08) vs (5.39±1.12)分]上两组差异有统计学意义(P<0.05)。结论:右侧腋窝-双侧乳晕入路达芬奇机器人甲状腺切除术在一定条件下是安全有效的,在降低术中出血量及甲状旁腺的损伤率上可能更具有优势,并且术后患者疼痛程度低、美容效果好。
Objective:To explore the safety and short-term efficacy of Da Vinci robotic thyroidectomy via the right axillary-bilateral areola approach.Methods:A retrospective analysis was performed on 185 patients diagnosed with thyroid cancer who underwent thyroidectomy at the general surgery department of the 940th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from January 2018 to June 2021.Among them, 87 patients underwent Da Vinci robot assisted surgery(robot group) and 98 patients underwent traditional open surgery(traditional operation group).The follow-up data were intercepted until 3 months after operation.The operation time, intraoperative blood loss, intraoperative nerve injury rate, intraoperative parathyroid injury rate, central lymph node dissection, drainage days, total drainage fluid, incision complication rate, postoperative pain score, postoperative feeling of the operation area in 3 months, postoperative beauty score in 3 months and other indicators were compared between the two groups.Results:There was no significant difference between the two groups in tumor location,tumordiameter,gender,body mass index,central lymph node dissection,drainage days,total drainage fluid,nerve injuryrate,incidence of incision complications,and 72 h postoperative pain score(P> 0. 05). The differences of age[(38. 60 ± 10. 00) vs(45. 95 ± 10. 79) years],the operation time[(178. 80 ± 43. 58) vs(136. 19 ± 43. 22) mi-nutes],intraoperative bleeding[(27. 01 ± 21. 81) vs(36. 84 ± 30. 31)mL],parathyroid injury rate( 26. 44 % vs42. 86%),24 h postoperative pain score [(3. 33 ± 0. 58) vs(4. 47 ± 0. 68)],48 h postoperative pain score [(1. 62± 0. 58) vs(2. 19 ± 0. 73)],neck sensory abnormality rate in 3 months after operation(3. 45% vs 11. 22%),andcosmetic score in 3 months after operation [(8. 60 ± 1. 08) vs(5. 39 ± 1. 12) points]between the two groups werestatistically significant(P< 0. 05).Conclusion:Da Vinci robotic thyroidectomy with the right axillary-bilateral are-ola approach is
作者
陈超
于建平
李洪涛
马有伟
李安东
何清远
卢顺利
韩晓鹏
CHEN Chao;YU Jianping;LI Hongtao;MA Youwei;LI Andong;HE Qingyuan;LU Shunli;HAN Xiaopeng(The First Clinical Medical College of Gansu University of Chinese Medicine,Gansu Lanzhou 730000,China;Department of General Surgery,the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Gansu Lanzhou 730050,China;Department of General Surgery,Gansu Provincial Central Hospital,Gansu Lanzhou 730070,China)
出处
《现代肿瘤医学》
CAS
北大核心
2023年第6期1034-1039,共6页
Journal of Modern Oncology
基金
甘肃省自然科学基金(编号:20JR5RA599)
甘肃省青年科技基金(编号:21JR7RA013)。
