分化型甲状腺癌的微创手术治疗

Minimal incision surgery with endoscope-assistant for differentiated thyroid cancer

目的:探讨将腔镜技术应用于分化型甲状腺癌的手术治疗的近期疗效及适应证。方法:回顾性分析56例分化型甲状腺癌在腔镜辅助下手术(研究组)和传统手术(对照组)治疗,在疗效、美容效果、合并症、手术时间、出血量等方面的差异。两组均行甲状腺癌联合根治手术—甲状腺切除术加同侧颈淋巴结清扫术。结果:两组患者经5-36个月的随访均无复发和转移;在手术切除范围相同的情况下,手术时间上研究组较对照组手术时间延长,存在明显差异(P≤0.05);术中出血量研究组较对照组增加(P≤0.05);术后引流量研究组与对照组未见明显差异(P≥0.5);美观度研究组明显优于对照组(P≤0.01)。结论:腔镜辅助下甲状腺癌联合根治手术是安全可行的,美容效果明显,但在手术时间、术中出血量方面劣于传统手术,需要严格掌握适应证。

Objective ：To explore the early therapeutic effect and indication of endoscope technology for differentiated thyroid cancer. Methods ： To review 56 patients with differentiated thyroid carcinoma for therapeutic effect, cosmetic effect, complication, operation time, blood loss between endoscopic surgery （ research group） and traditional surgery（ control group）. The two groups were both underwent total thyroidectomy and lateral neck dissection. Results：All the patients in two groups were not recurrent and metastatic with in 5 - 30 months follow - up. The operation time in research group was longer than control group with the same surgical resection range（ P≤0. 05 ）. The blood loss during operation was more than control group（ P≤0.05 ）. There was no statistical difference for post - operative drainage between two groups （ P ≥ 0.5 ） . The cosmetic effect in research group was more satisfied than traditional group （ P ≤0. 01 ）. Conclusion：The minimal incision surgery with endoscope -assistant for thyroid cancer is safe and feasible with strict indication. It has good cosmetic effect, but the operation time and blood loss were longer and more than traditional surgery.