经胸乳入路腹腔镜下改良淋巴结清扫术在甲状腺癌中的应用价值

Application Value of Laparoscopic Carcinoma Cervical Lymph Node Dissection through Breast Approach in Thyroid Cancer

目的:探讨经胸乳入路腹腔镜下改良淋巴结清扫术治疗甲状腺癌的应用价值。方法:选择2014年3月-2015年3月在本院接受手术治疗的31例甲状腺癌患者为研究对象,根据手术方法的不同分为腹腔镜组6例和开放组25例,比较分析两组患者术中及术后情况。结果:所有患者均成功完成手术,腹腔镜组术中平均出血量少于开放组,手术时间长于开放组,引流管引流量少于开放组,住院时间短于开放组,以上比较差异均有统计学意义(P<0.05);两组淋巴结清扫数目比较,差异无统计学意义(P>0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论:腹腔镜下甲状腺癌改良颈部淋巴结清扫术安全可行,同开放手术方式相比虽然手术时间较长,但腹腔镜手术具有术中出血量少、术后疼痛轻微、切口美观及术后恢复快等优点,值得临床推广应用。

Objective：To discuss the application value of laparoscopic carcinoma cervical lymph node dissection through breast approach in thyroid cancer.Method：31 cases of thyroid cancer patients who received surgical treatment in our hospital from March 2014 to March 2015 were selected as the research objects.They were divided into laparoscope group（6 cases） and open group（25 cases） according to different operation methods.The conditions of the two groups during and after surgery were compared and analyzed.Result：All patients were successfully operated.The average bleeding volume of the laparoscope group was less than that of the open group,the operation time of the laparoscope group was longer than that of the open group,the volume of drainage by drainage tube in the laparoscope group was less than that in the open group,the average length of hospital stay of the laparoscope group was shorter than that of the open group,the differences above were statistically significant（P〈0.05）.The differences in the average number of lymph nodes dissection and total postoperative complication rate between the two groups were not statistically significant（P〉0.05）.Conclusion：Laparoscopic carcinoma cervical lymph node dissection in thyroid cancer is safe and feasible.Compared with the traditional operation mode,although the operation time of the laparoscopic surgery is longer,it has the advantages of less intraoperative hemorrhage quantity,mild postoperative pain,beautiful incision and faster postoperative recovery,which is worthy of clinical application.