腋窝入路与颈部入路腔镜甲状腺手术的对比研究

Comparative study of endoscopic thyroidectomy between axillary approach and neck approach

目的对比分析腋窝入路与颈部入路腔镜甲状腺手术的临床效果。方法回顾性分析2016年5月至2018年5月46例单侧甲状腺良性疾病患者的临床资料,根据患者意愿,其中21例经腋窝入路腔镜甲状腺部分切除(A组),25例经颈部入路腔镜甲状腺部分切除(B组),对比分析2组手术时间、术中出血量、术后引流管引流量、术后住院时间、切口满意度情况。结果 2组患者手术均获成功,A组手术时间、术后引流管引流量、术后住院时间显著大于B组,差异均有统计学意义(P<0.01);A组术后切口满意度显著大于B组,差异有统计学意义(P<0.01);A组术后并发症显著大于B组,差异有统计学意义(P<0.01);2组术中出血量比较,差异无统计学意义(P>0.05)。结论腋窝入路和颈部入路腔镜甲状腺手术都是安全可行的方法,但腋窝入路腔镜甲状腺手术术后患者切口满意度优于颈部入路腔镜甲状腺手术。

Objective To compare the clinical effects of endoscopic thyroid surgery with axillary approach and neck approach. Methods The clinical data of 46 patients with unilateral thyroid benign disease from May 2016 to May 2018 were retrospectively analyzed.According to the patient′s wishes,21 patients were in group A,and the thyroid partial resection was performed by transforaminal approach;25 patients were in group B,and partial thyroidectomy was performed by transthoracic approach.The operation time,intraoperative blood loss,postoperative drainage tube drainage,postoperative hospital stay,and incision satisfaction were compared between the two groups. Results The operation of the two groups was successful.The operation time,drainage volume and postoperative hospital stay in group A were significantly higher than those in group B ( P <0.01).The incision satisfaction of group A was significantly higher than that of group B,and the difference was statistically significant ( P <0.01).The postoperative complications in group A were significantly greater than those in group B,and the difference was statistically significant ( P < 0.01 ).There was no significant difference in the amount of intraoperative blood loss between the two groups ( P >0.05). Conclusion Axillary approach and cervical approach laparoscopic thyroid surgery are safe and feasible methods,but the incision satisfaction of patients with axillary approach laparoscopic thyroid surgery is better than that of cervical approach laparoscopic thyroid surgery.