侧方入路在甲状腺肿瘤再次手术中的应用

The application of lateral approach in the reoperation of thyroid tumor

目的:探讨不同手术入路选择在甲状腺再次手术中的应用。方法:回顾性分析85例甲状腺肿瘤需再次手术病人的临床资料,根据手术入路分为正中入路组(正中组)38例和侧方入路组(侧方组)47例。比较2组病人手术时间、术中出血量和术后并发症发生情况。结果:侧方组手术时间为(1.5±0.5)h,显著短于正中入路组的(2.0±0.5)h(P<0.01);侧方组术中出血量为(35.5±6.5)m L,显著少于正中组的(55.8±8.7)m L(P<0.01)。侧方组术后并发症总发生率为17.03%,低于正中组的39.47%(P<0.05)。结论:甲状腺肿瘤再次手术中应用侧方入路有助于缩短手术时间,减少术中出血量和手术并发症发生。

Objective： To explore the application value of different approaches in the reoperation of thyroid. Methods： The clinical data of 85 thyroid tumor patients treated with reoperation were retrospectively analyzed. The patients were divided into the middle approach group（ 38 cases,middle group） and lateral approach group（ 47 cases,lateral group） according to the surgical approach. The operation time,intraoperative blood loss and postoperative complications between two groups were compared. Results： The mean operative time in lateral group[（ 1. 5 ± 0. 5） h] was significantly shorter than that in middle group[（ 2. 0 ± 0. 5） h]（ P〈0. 01）. The blood loss in lateral group[（ 35. 5 ± 6. 5） m L]was significantly less than that in middle group[（ 55. 8 ± 8. 7） m L]（ P〈0. 01）. The overall incidence of postoperative complications in lateral group（ 17. 03%） was lower than that in middle group（ 39. 47%）（ P〈0. 05）. Conclusions： Compared with the conventional middle approach,the lateral approach in the reoperation of thyroid tumor can help to shorten the operation time,and reduce the intraoperative blood loss and incidence of postoperative complications.