摘要
目的对比双侧腋窝乳晕入路腔镜甲状腺手术(BABA-ET)和开放手术对甲状腺微小乳头状癌(PTMC)的治疗效果。方法回顾性收集2022年10月至2023年10月在重庆市綦江区人民医院经手术治疗PTMC患者107例,根据手术方式分为腔镜组(39例)、开放组(68例),比较2组患者的手术效果、术后并发症及美容满意度等情况。结果与开放组比较,腔镜组患者年龄较小[(40.51±5.67)岁vs.(51.04±8.58)岁],手术时间较长[113.00(105.00~123.00)min vs.95.00(86.00~105.75)min],术后引流量较多[(103.41±21.57)mL vs.(78.71±19.47)mL],差异均有统计学意义(P<0.05),2组患者暂时性喉返神经损伤、暂时性低钙、疼痛评分、术后出血等比较,差异均无统计学意义(P>0.05),2组患者术后均未出现乳糜漏、感染。腔镜组患者术后满意度较开放组高(89.74%vs.41.18%),差异有统计学意义(P<0.05)。截至末次随访,2组患者均未出现肿瘤复发和转移。结论BABA-ET对PTMC的治疗效果与开放手术相当,并且美容效果较好。因此,对于担心术后颈部瘢痕的PTMC患者,BABA-ET是一种较为理想的手术方式。
Objective To compare the efficacy of bilateral axillary areolar approach laparoscopic thyroid surgery(BABA-ET)and open surgery in the treatment of micropapillary thyroid carcinoma(PTMC).Methods A total of 107 patients were retrospectively collected from October 2022 to October 2023 at the People′s Hospital of Qijiang District,Chongqing Municipality,who were treated surgically for PTMC,and were categorized into the endoscopic group(39 patients)and the open group(68 patients)according to the surgical modality,and were compared with the surgical results,postoperative complications,and cosmetic satisfaction in the 2 groups.Results Compared with the open group,patients in the endoscopic group were younger[(40.51±5.67)years vs.(51.04±8.58)years]and the operation time was longer[113.00(105.00-123.00)min vs.95.00(86.00-105.75)min].and the postoperative drainage was higher[(103.41±21.57)mL vs.(78.71±19.47)mL],and the differences were statistically significant(P<0.05).There were no statistically significant differences in the comparison of temporary recurrent laryngeal nerve injury,temporary hypocalcemia,pain scores and postoperative bleeding between the two groups(P>0.05),and no celiac leakage or infection was observed in the postoperative period of patients in the 2 groups.The postoperative satisfaction of patients in the laparoscopic group was higher than that in the open group(89.74%vs.41.18%),and the difference was statistically significant(P<0.05).By the final follow-up,no tumor recurrence or metastasis had occurred in the 2 groups.Conclusion BABA-ET is comparable to open surgery for PTMC and has a better cosmetic outcome.Therefore,BABA-ET is a more ideal procedure for patients with PTMC who are concerned about postoperative neck scarring.
作者
朱红杨
张翼
樊昆
黄锡明
刘津杉
ZHU Hongyang;ZHANG Yi;FAN Kun;HUANG Ximing;LIU Jinshan(Department of Gastrointestinal/Thyroid and Breast/Hernia surgery,the People′s Hospital of Qijiang District,Chongqing,401420,China)
出处
《现代医药卫生》
2024年第20期3494-3497,3501,共5页
Journal of Modern Medicine & Health
关键词
甲状腺微小乳头状癌
内窥镜
双侧腋乳入路
Papillary thyroid microcarcinoma
Endoscope
Bilateral axillo-breast approach
