摘要
目的:比较经口腔前庭入路与经胸乳入路行腔镜单侧甲状腺乳头状癌手术的临床疗效。方法:回顾分析2019年9月至2021年6月收治的150例甲状腺乳头状癌患者的临床资料,根据手术路径分为经口腔前庭入路组(经口组,n=68)与经胸乳入路组(经胸乳组,n=82)。比较两组患者临床资料(如年龄、性别、侧别、肿瘤直径、BMI等)、手术时间、术后引流量、淋巴结清扫数量、住院时间、并发症发生率及术后患者美观满意度。结果:两组术后引流量、住院时间、手术并发症发生率差异无统计学意义(P>0.05)。经口组手术时间长于经胸乳组[(194.1±35.1)min vs.(177.0±40.8)min,P<0.05];但在经口组完成20例后,经口组与经胸乳组手术时间差异无统计学意义[(188.3±32.7)min vs.(177.0±40.8)min,P=0.177]。经口组中央区淋巴结清扫数量多于经胸乳组[(7.1±4.5)枚vs.(3.8±3.1)枚,P<0.01],美观满意度评分高于经胸乳组[(9.08±0.78)分vs.(8.02±0.87)分,P<0.01]。结论:与经胸乳入路腔镜甲状腺手术相比,经口腔前庭入路手术时间较长,但清扫中央区淋巴结数量更多,美容满意度更高,值得临床推广应用。
Objective:To compare the clinical efficacy of endoscopic thyroidectomy for unilateral thyroid papillary carcinoma via transoral vestibular approach and chest-breast approach.Methods:The clinical data of 150 patients with unilateral thyroid papillary carcinoma admitted from Sep.2019 to Jun.2021 were retrospectively analyzed.Patients were divided into the transoral vestibular approach group(transoral group,n=68)and the chest-breast approach group(chest-breast group,n=82)according to the surgical approach.The basic information(such as age,gender,side of the tumor,tumor size,BMI,etc.),operative time,postoperative drainage,number of lymph nodes dissected,hospital stay,postoperative complications,and cosmetic satisfaction were compared between the 2 groups.Results:The postoperative drainage,hospital stay and complications were not statistically significantly different between the two groups(P>0.05).The operative time of the transoral group was longer than that in the chest-breast group[(194.1±35.1)min vs.(177.0±40.8)min,P<0.05].Nevertheless,after completion of 20 operations in the transoral group,the difference in operative time between the transoral group and the chest-breast group was not statistically significant[(188.3±32.7)min vs.(177.0±40.8)min,P=0.177].The number of lymph node dissected in the central area in the transoral group was more than in the chest-breast group,with a statistically significant difference[(7.1±4.5)vs.(3.8±3.1),P<0.01].Postoperative cosmetic satisfaction score in the transoral group was higher than that in the chestbreast group[(9.08±0.78)vs.(8.02±0.87),P<0.01].Conclusions:Compared with chest-breast approach,endoscopic thyroidectomy via transoral approach has a longer operation time,but clears more lymph nodes in the central region and provides higher cosmetic satisfaction,it is worthy of clinical promotion.
作者
赵明
郝丽
王睿
张林
ZHAO Ming;HAO Li;WANG Rui(Department of Thyroid Surgery,Affiliated Qingdao Central Hospital,Qingdao University,Qingdao 266042,China)
出处
《腹腔镜外科杂志》
2023年第3期166-170,共5页
Journal of Laparoscopic Surgery
