摘要
目的探讨全乳晕入路腔镜手术在甲状腺微小乳头状癌根治术中的应用价值。方法回顾性选取2019年9月至2023年6月徐州市中心医院与徐州医科大学附属第三医院收治的80例单侧甲状腺微小乳头状癌患者作为研究对象,甲状腺切除方式均采用峡部+患侧甲状腺全切及中央区淋巴结清扫,根据手术入路的不同,分为腔镜组(40例)和开放组(40例)。腔镜组行全乳晕入路腔镜下手术,开放组行颈前切口入路手术,比较两组患者的手术相关指标、并发症发生情况以及术后满意度。结果腔镜组术中出血少于开放组,差异有统计学意义(P<0.05);两组患者术后24 h引流量比较,差异无统计学意义(P>0.05);腔镜组切开总长度短于开放组,差异有统计学意义(P<0.05);腔镜组术后24 h疼痛评分低于开放组,差异有统计学意义(P<0.05);腔镜组的并发症总发生率低于开放组,差异有统计学意义(P<0.05);腔镜组术后美容满意度评分高于开放组,瘢痕自我关注度得分低于开放组,差异有统计学意义(P<0.05)。结论全乳晕入路腔镜下甲状腺微小乳头状癌根治术术野清晰,创伤小,出血少,术后美容效果理想,还可减少手术相关并发症。
Objective To evaluate the value of endoscopic surgery through total areola approach in radical thyroidectomy for micro papillary thyroid carcinoma.Methods A total of 80 patients with unilateral micro papillary thyroid carcinoma treated in Xuzhou Central Hospital and the Third Affiliated Hospital of Xuzhou Medical University from September 2019 to June 2023 were retrospectively selected as the study objects.The thyroidectomy methods were isthmus+total thyroidectomy on the affected side and central lymph node dissection.The patients were divided into endoscopic group(40 cases)and open group(40 cases).Endoscopic surgery was performed by the total areola approach in the endoscopic group,and anterior cervical incision was performed in the open group.Surgical indicators,complications and postoperative satisfaction were compared between the two groups.Results The intraoperative bleeding in the endoscopic group was less than that in the open group,the difference was statistically significant(P<0.05).There was no significant difference in drainage volume 24 h after operation between the two groups(P>0.05).The total incision length in the endoscopic group was shorter than that in the open group,and the difference was statistically significant(P<0.05).Pain score 24 h after surgery in endoscopic group was lower than that in open group,the difference was statistically significant(P<0.05).The total incidence of complications in endoscopic group was lower than that in open group,and the difference was statistically significant(P<0.05).The score of postoperative aesthetic satisfaction in the endoscopic group was higher than that in the open group,and the score of scar self-attention was lower than that in the open group,with statistical significances(P<0.05).Conclusion Endoscopic surgery through total areola approach in radical thyroidectomy for micro papillary thyroid carcinoma has clear operation field,less trauma,less bleeding,ideal postoperative aesthetic effect,and can reduce the complications related to surgery.
作者
张洪伟
贾高磊
ZHANG Hongwei;JIA Gaolei(Department of General Surgery,the Third Affiliated Hospital of Xuzhou Medical University,Jiangsu Province,Xuzhou221003,China;Department of Vascular,Thyroid,Hernia and Minimally Invasive Surgery,Xuzhou Central Hospital,Jiangsu Province,Xuzhou221006,China)
出处
《中国当代医药》
CAS
2024年第8期76-79,共4页
China Modern Medicine
关键词
全乳晕入路
腔镜
甲状腺
微小乳头状癌
开放手术
Total areola approach
Endoscope
Thyroid
Micro papillary carcinoma
Open surgery
