腔镜下口底入路辅助甲状腺癌中央区淋巴结清扫效果分析

Analysis of effects of endoscopic mouth floor approach combined with central lymph node dissection of thyroid carcinoma

目的分析腔镜下口底入路辅助甲状腺癌中央区淋巴结清扫术的效果。方法随机将88例甲状腺癌患者分为A、B两组,均行经胸乳入路腔镜甲状腺切除术,A组在B组基础上,加以口底入路辅助中央区淋巴结清扫术,比较两组的淋巴结清扫数、并发症发生率及随访2年复发率。结果 A组中央区淋巴结清扫数(7.52±1.46)个多于B组(6.15±1.14)个(P<0.05);A组口腔感染率为8.89%;两组术中出血量、住院时间、一过性声音嘶哑、喉返神经暂时性损伤发生率比较均无显著差异(P>0.05);A组术后2年复发率明显低于B组(P<0.05)。结论与单纯腔镜下经胸乳入路甲状腺切除术相比,口底入路辅助中央区淋巴结清扫,对中央区淋巴结清扫更彻底,术后2年复发率较低,且除口腔感染风险外,不增加并发症发生率。

Objective To analyze the effects of endoscopic mouth floor approach combined with central lymph node dissection of thyroid carcinoma. MeAods A total of 88 patients with thyroid carcinoma were randomly divided into group A and group B. The two groups received e ndoscopic thyroidectomy via breast approach, and group A was additionally treated with mouth floor approach combined with central lymph node dissection on the basis of group B. The count of lymph nodes dissected, incidence of complication and recurrence rate during tw-o-year follow-up vision betw-een the two groups were compared. Results The count of central lymph nodes dissected in group A 7.52±1.46 was more than that in group B 6.15±1.14 （P 〈 0.05）; the oral infection rate in group A was 8.89%; there was no significant difference in the incidence of intraoperative blood loss, length of stay （LOS）, transient hoarseness and temporary injury of recurrent laryngeal nerve between the tw,o groups （P 〉 0.05）; the recurrence rate within two years after the operation in group A was significantly lower than that in group B （P 〈 0.05）. Conclusion Compared with simple endoscopic thyroidectomy via breast approach, mouth floor approach combined with central lymph node dissection can dissect the central lymphnodes more thoroughly; the recurrence rate two years after the operation is lower; except for oral infection risk, the incidence of complication does not increase.