摘要
目的:分析比较经口腔前庭入路与经腋窝入路腔镜手术治疗甲状腺癌的临床效果。方法:回顾性分析2020年6月-2022年12月在笔者医院接受手术治疗的144例甲状腺癌患者临床资料,依据手术方式不同分为A组(n=45,传统开放手术)、B组(n=50,经口腔前庭入路腔镜手术)及C组(n=49,经腋窝入路腔镜手术),比较三组手术相关指标、术后不同时间点疼痛评分、美学效果[温哥华瘢痕量表(Vancouver scar scale,VSS)]及术后并发症发生率。结果:B组手术时间长于A、C两组(P<0.05);B、C两组术中出血量、引流量均少于A组,术中淋巴结清扫数目均多于A组,住院时间短于A组,差异均有统计学意义(P<0.05);B、C两组术后1 d、术后3 d、术后1个月、术后3个月疼痛VAS评分均低于A组,差异有统计学意义(P<0.05);术后3个月B、C两组VSS评分均低于A组,且B组VSS评分较C组更低,差异有统计学意义(P<0.05);三组间术后并发症比较差异无统计学意义(P>0.05)。结论:与传统开放术比较,经口腔前庭入路与经腋窝入路腔镜手术治疗效果均更好,均可有效减轻术后疼痛,同时经口腔前庭入路具有术中淋巴结清扫数目多,美学效果好等优势,经腋窝入路具有手术时间短的优点,临床可依据不同情况选择合适的手术方案。
Objective To analyze and compare the clinical effects of endoscopic transoral vestibular approach and transaxillary approach in the treatment of thyroid cancer.Methods A total of 144 patients with thyroid cancer who underwent surgical treatment in the author's hospital from June 2020 to December 2022 were reviewed.They were divided into group A(n=45,traditional open surgery),group B(n=50,endoscopic transoral vestibular approach)and group C(n=49,endoscopic transaxillary approach)according to different surgical methods.Surgery related indicators,pain scores at different time points after surgery,wound cosmetic effect[Vancouver scar scale(VsS)]and the incidence of postoperative complications were compared among the three groups.Results The operation time of group B was longer than that of group A and group C(P<0.05).The intraoperative bleeding volume and drainage volume of group B and group C were less than those of group A.Lymph nodes removed during operation were more than group A,and hospital stay was shorter than that of group A(all P<0.05).The VAS scores of group B and group C on day 1 and day 3 after operation,and at 1 month and 3 months after operation were lower than those of group A(P<0.05).At 3 months after operation,the VSS scores of group B and group C were lower than those of group A,and the VSS scores of group B were lower than those of group C(P<0.05).The incidence rates of postoperative complications in the three groups were close(P>0.05).Conclusion Compared with traditional open surgery,endoscopic transoral vestibular approach and transaxillary approach are more effective in the treatment of patients with thyroid cancer,which can effectively relieve postoperative pain.In addition,endoscopic transoral vestibular approach can make more lymph nodes removed during operation,with good cosmetic effect.Transaxillary approach has the advantages of short operation time.In clinical practice,appropriate surgical scheme can be selected according to actual condition.
作者
凌尧
兰雪君
欧敏
LING Yao;LAN Xuejun;OU Min(Department of Thyroid Surgery,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China;Medical Examination Center,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China;Department of Intensive Care Medicine,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)
出处
《中国美容医学》
CAS
2024年第5期13-17,共5页
Chinese Journal of Aesthetic Medicine
关键词
经口腔前庭入路
经腋窝入路
甲状腺癌
手术治疗
美学效果
transoral vestibular approach
transaxillary approach
thyroid cancer
surgical treatment
aesthetic effect
