摘要
目的:比较经口腔前庭入路与经腋窝入路腔镜单侧甲状腺癌根治术的治疗效果。方法:选取2021年7月至2023年6月收治的100例单侧甲状腺微小乳头状癌患者的临床资料,其中50例经口腔前庭入路行腔镜单侧甲状腺癌根治术(经口腔组),50例经腋窝入路行免充气全腔镜单侧甲状腺癌根治术(经腋窝组),对比分析两组临床疗效。结果:两组手术时间、术中出血量、术后第7天颈胸部疼痛评分、总并发症发生率差异无统计学意义(P>0.05);经口腔组术后第1天引流量少于经腋窝组,引流管放置时间短于经腋窝组(P<0.01),清扫中央区淋巴结数量多于经腋窝组(P<0.01),患者满意度、术后第1天颈胸部疼痛评分高于经腋窝组(P<0.01),疤痕评分低于经腋窝组(P<0.01)。结论:相较经腋窝入路,经口腔前庭入路腔镜手术治疗单侧甲状腺癌清扫中央区淋巴结数量更多,患者满意度更高,美容效果更好,可在美容需求较高的患者中推广。
Objective:To compare the treatment effect of endoscopic unilateral radical thyroidectomy via transoral vestibular approach and transaxillary approach.Methods:The clinical data of 100 patients with unilateral papillary thyroid microcarcinoma from Jul.2021 to Jun.2023 were selected,including 50 cases of endoscopic unilateral radical thyroidectomy via transoral vestibular approach(transoral group)and 50 cases of gasless endoscopic unilateral radical thyroidectomy via transaxillary approach(transaxillary group).The clinical efficacy of two groups were compared.Results:There were no significant differences in operation time,intraoperative blood loss,postoperative cervicothoracic pain score(day 7)and total complication rate between the two groups(P>0.05).The drainage v olume(day 1)and drainage tube placement time after surgery in the transoral group were less than those in the transaxillary group(P<0.01).The number of lymph nodes dissected in the central area in the transoral group was more than that in the transaxillary group(P<0.01).The satisfaction degree and postoperative cervicothoracic pain score(day 1)in the transoral group were higher than those in the transaxillary group(P<0.01).The scar score in transoral group was lower than in transaxillary group(P<0.01).Conclusions:Compared with the transaxillary approach,the transoral vestibular approach can be used to dissect more central lymph nodes,with the higher patient satisfaction and better cosmetic effect in the treatment of unilateral thyroid cancer under endoscopy,which can be promoted in patients with higher cosmetic demands.
作者
孙思雨
张松
钱立宇
王岩岩
姚廷敬
SUN Siyu;ZHANG Song;QIAN Liyu(Department of Oncological Surgery,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233000,China)
出处
《腹腔镜外科杂志》
2024年第9期647-651,共5页
Journal of Laparoscopic Surgery
基金
蚌埠医学院自然科学重点项目(2020byzd124)。
关键词
甲状腺微小乳头状癌
内窥镜检查
经口腔前庭入路
经腋窝入路
疗效比较研究
Micropapillary carcinoma of thyroid
Endoscopy
Transoral vestibular approach
Transaxillary approach
Comparative effectiveness research
