小切口腔镜辅助甲状腺手术治疗甲状腺结节的前瞻性临床研究

A Prospective Clinical Research of Minimally Invasive Video-assisted Thyroidectomy in Treating Thyroid Nodule

目的探讨小切口腔镜辅助甲状腺手术(minimally invasive video-assisted thyroidectomy,MIVAT)治疗甲状腺结节的安全性及疗效。方法本研究为前瞻性随机对照研究,研究对象为我院2014年3月至2015年5月住院的甲状腺结节患者。80例患者随机接受MIVAT及传统开放手术,每组40例。结果两组患者年龄、性别、结节大小、病理诊断、术式无统计学差异,均顺利完成手术,无死亡病例。MIVAT组切口长度、术后引流留置时间、美容及吞咽满意度优于开放手术组,MIVAT组手术时间长于开放手术组,两组喉返神经损伤及甲状旁腺功能减退发生率相当。结论治疗较小甲状腺结节时,MIVAT手术安全性与开放手术相当,但可显著缩小切口,提高美容效果,改善吞咽不适感。

Objective To evaluate the safety and effective of minimally invasive video-assisted thyroidectomy for treating thyroid nodule. Methods This research is a prospective randomized controlled trial, and patients with thyroid nodules admitted to our hospital from March 2014 to May 2015 were identified. There were 80 patients randomly accepted MIVAT or traditional open thyroidectomy, with 40 patients in each group. Results There were no difference in age, sex, the size of nodules, pathological diagnosis, and surgical procedures. All the patients successfully accepted operation, with no case died. Patients who underwent MIVAT had smaller size of incision, less blood loss, less volume and days of drainage, better cosmetic and swallow satisfaction, and longer operation time. There were no difference in the rates of injury of recurrent laryngeal nerve and hypoparathyroidism. Conclusions MIVAT and open thyroidectomy acquire similar safety effect when treating small thyroid nodule, but MIVAT has smaller size of incision and better cosmetic and swallow satisfaction.