内镜下经胸乳甲状腺切除手术与开放甲状腺手术的临床效果比较

A comparative study for clinic effect of endoscopic thyroidectomy via chest and breasts approach and conventional thyroidectomy

目的比较内镜下经胸乳甲状腺切除手术与开放甲状腺手术的临床疗效。方法选择该院收治的甲状腺结节患者320例,其中120例采用内镜下经胸乳甲状腺切除术,200例选择传统开放式甲状腺切除手术。观察比较两种术式的手术时间、切口长度、术中失血量、术后住院时间、术后疼痛评估。对两组患者术后进行随访3个月,记录两组并发症发生情况、肿瘤复发率,并进行美观满意度调查。结果胸前壁乳晕入路内镜甲状腺手术患者的切口长度、术中失血量、术后第1天和第3天VAS疼痛评分及术后3个月时随访美观满意度均明显优于行开放甲状腺手术患者(P<0.05),而两组手术时间、术后住院时间、肿瘤复发率及术后并发症发生率差异无显著性(P>0.05)。结论胸前壁乳晕入路内镜甲状腺手术是一种安全有效的微创美容手术,但远期疗效有待进一步研究。

[Objective] To compare the clinic effect of endoscopic thyroidectomy via chest and breasts approach and conventional thyroidectomy.[Methods] 320 patients with thyroid nodule were divided into two groups to perform endoscopic thyroidectomy via chest in 120 cases and breasts approach and conventional thyroidectomy in 200 cases respectively.The total operative time,the incisional length,intraoperative bleeding volume,the mean hospital stay after surgery,postoperative pain were compared.With 3 months postoperative follow-up,the surgical complications,the rate of relapse and cosmetic results were compared.[Results] The incisional length,intraoperative bleeding volume,postoperative pain and the cosmetic result in endoscopic thyroidectomy via chest and breasts approach were improved obviously than that in conventional thyroidectomy （P0.05）.There was no significant difference between two groups at the total operative time,the mean hospital stay after surgery,the rate of relapse and the surgical complications （P〈0.05）.[Conclusions] Endoscopic thyroidectomy via chest and breasts approach is a safe and effective method of thyroid surgery.But long-term efficacy are needed to study.