甲状腺乳头状癌全腔镜手术临床分析

Clinical analysis of totally endoscopic surgery for differentiated thyroid carcinoma

目的探讨甲状腺乳头状癌全腔镜手术的临床效果。方法选取2011-01—2017-08间在郑州大学第一附属医院接受手术的81例甲状腺乳头状癌患者。将经胸乳入路全腔镜手术的45例患者作为腔镜手术组,将实施传统开放手术的36例患者作为传统手术组。比较2组手术时间、术中出血量和术后24 h内引流量、住院时间、美容满意度评分及并发症。结果腔镜手术组术中出血量少、术后住院时间短、疼痛轻;但手术时间、术后24 h引流量均大于传统手术组,差异均有统计学意义(P<0.05)。2组并发症发生率差异无统计学意义(P>0.05)。术后随访6个月,均未无出现肿瘤复发转移。结论全腔镜手术治疗甲状腺乳头状癌,术中出血少、术后恢复快、美容效果肯定,安全、有效。

Objective To investigate the clinical effect of totally endoscopic surgery for differentiated thyroid carcinoma（ DTC）.Methods The data of 81 patients with DTC who were performed in laparoscopic surgery in our hospital from January 2011 to December 2017 were retrospectively analyzed. The patients aged from 24 to 67 years old. Among them,45 cases were treated with transthoracic approach total endoscopic surgery and 36 cases were treated with conventional open surgery. The operative time,bleeding volume,drainage volume within 24 hours after operation,postoperative hospital stay,cosmetic satisfaction score,and surgical complications were compared between the two groups. Results In the laparoscopic surgery group,the amount of blood loss was reduced,postoperative hospital stay was short,and pain was light. However,the operation time and the drainage within 24 hours after operation was greater than that of the conventional surgery group. The comparison was statistically significant（ P 〈 0. 05）. The incidence of surgical complications was not significantly different between the two groups（ P 〉 0. 05）. No tumor recurrence and metastasis occurred after six months’ follow-up. Conclusion Totally endoscopic surgery for DTC has reduced bleeding,rapid recovery,and good cosmetic results. It is a safe,effective and feasible solution which is worthy of clinical application.