摘要
目的探讨不同手术入路在甲状腺癌复发再次手术中的应用效果。方法选取在本院就诊的102例甲状腺癌复发需再次手术患者,随机分为观察组(n=51)和对照组(n=51)。观察组实施胸骨舌骨肌-胸骨甲状肌间隙入路手术,对照组实施经颈白线入路手术。比较两组甲状腺显露效果、手术相关指标(手术时间、术中出血量、住院时间)及术后并发症(喉返神经损伤、甲状旁腺损伤)发生率。结果观察组甲状腺上极、下极、外侧显露效果评分明显高于对照组(P<0.05),甲状腺峡部显露效果两组比较无统计学差异(P>0.05);观察组手术时间及住院时间均短于对照组(P<0.05),术中出血量少于对照组(P<0.05),完整切除率高于对照组(P<0.05),术后暂时性喉返神经损伤、暂时性甲状旁腺损伤、伤口肿胀等并发症的发生率均低于对照组(P<0.05)。结论甲状腺癌复发再次手术中应用胸骨舌骨肌-胸骨甲状肌间隙入路有利于显露局部结构,减轻创伤,提高手术效果,加快术后恢复,降低术后并发症发生率。
Objective To explore the application of different surgical approaches in reoperation for recurrence of thyroid cancer.Methods 102 patients with recurrent thyroid cancer who needed reoperation were divided into a observation group(n=51)and a control group(n=51)according to the surgical approach.The observation group underwent viacervical strap muscles approach surgery,while the control group underwent transcervical white line surgery.The thyroid exposure effect,operation related indicators(operation time,intraoperative bleeding volume,hospital stay)and postoperative complications(recurrent laryngeal nerve injury,parathyroid injury)were compared between the two groups.Results The exposure effect score of superior,inferior and lateral thyroid gland in the observation group were significantly higher than those in the control group(P<0.05),and there was no difference in the exposure effect of isthmus of thyroid between the two groups(P>0.05).Compared with the control group,the operation time and hospitalization time was significantly shorter,and the amount of bleeding volume was significantly less in the observation group(P<0.05).The complete resection rate in the observation group was higher than that in the control group(P<0.05).The incidence of postoperative complications such as temporary recurrent laryngeal nerve injury,temporary parathyroid injury and wound swelling in the observation group were lower than those in the control group(P<0.05).Conclusion The application of viacervial strap muscles approach in reoperation for recurrent thyroid cancer is conducive to revealing local structure,alleviating trauma,improving surgical effect,speeding up postoperative recovery and reducing the incidence of postoperative complications.
作者
胡夏荣
谢楚平
陈思远
吴志明
梁子君
卢焕全
HU Xiarong;XIE Chuping;CHEN Siyuan;WU Zhiming;LIANG Zijun;LU Huanquan(General Surgery Department,Dongguan People's Hospital,Dongguan 523000,Guangdong,China)
出处
《中国现代手术学杂志》
2023年第6期444-448,共5页
Chinese Journal of Modern Operative Surgery
基金
东莞市科技特派员项目(20221800500302)。
关键词
甲状腺肿瘤
带状肌间入路
再手术
thyroid neoplasms
viacervical strap muscles approach
reoperation
