改良Miccoli手术治疗甲状腺微小乳头状癌的临床研究

The clinical research of the modified Miccoli operation in the treatment of papillary thyroid microcarcinoma

目的:评估改良Miccoli手术治疗甲状腺微小乳头状癌的安全性与合理性。方法:将2011年7月至2013年7月收治的65例甲状腺微小乳头状癌患者分为传统手术组与改良Miccoli组,对比分析两组患者术中淋巴结清扫数量、术中出血量、手术时间、术后并发症、术后切口长度、术后3 d平均引流量、术后住院时间。结果:两组患者术中出血量、术后切口长度、术后3 d平均引流量差异有统计学意义(P<0.05),改良Miccoli组较传统组手术时间延长。术中淋巴结清扫数量、术后住院时间两组差异无统计学意义(P>0.05)。两组患者术后均无严重并发症发生。结论:改良Miccoli手术安全可靠,较传统手术患者创伤小,术后颈部瘢痕小,在不增加手术并发症的前提下,可达到传统手术的淋巴结清扫程度。

Objective：To evaluate the safety and rationality of the modified Miccoli operation in the treatment of papillary thy- roid microcareinoma. Methods：From Jul. 2011 to Jul. 2013,65 patients with papillary thyroid microcareinoma were divided into the tra- ditional operation group and modified Miccoli group. The number of lymph nodes dissection, intraoperative blood loss, operative lime, postoperative complications, postoperative incision length, postoperative average drainage volume in the three days, and hospital stay af- ter operation were compared between the two groups. Results：There were statistically significant differences between the two groups in the blood loss, incision length, postoperative average drainage （ P 〈 0.05 ）. The operation time of modified Miceoli group was longer than that of the traditional group. The number of lymph node dissection and postoperative hospital stay time had no significant ditterenees be- tween the two groups （ P 〉 0.05 ）. No serious complications occurred in the 2 groups. Conclusions ： The modified Miecoli operation is safe and reliable. Compared with traditional operation, patients suffer fewer traumas, and have shorter neck scar. This operation can clean the same number of lymph nodes as traditional operation without increasing the operation complications.