经胸乳入路腔镜甲状腺切除术治疗甲状腺良性结节的疗效及手术切口美观度评价

The clinical effectiveness and cosmetic result of endoscopic thyroidectomy though chest-breast approach on benign thyroid nodules

目的:观察经胸乳入路腔镜甲状腺切除术治疗甲状腺良性结节的疗效,评价手术切口美观度。方法:选取2015年1月至2017年1月广西医科大学第十附属医院收治的80例甲状腺良性结节患者,按随机数字表法随机分为对照组和观察组,每组40例。对照组采用经颈部入路甲状腺肿物切除术治疗,观察组采用经胸乳入路腔镜甲状腺切除术治疗。比较两组围手术期相关指标、并发症发生情况及术后1年手术切口的美观度。结果:两组手术时间和切除肿物重量比较,差异无统计学意义(P>0.05),与对照组比较,观察组术中出血量、术后24h视觉模拟量表(VAS)评分、引流量、住院时间、并发症发生率、术后1年温哥华瘢痕评价量表(VSS)评分、患者瘢痕自我评分(PSAS)和观测者瘢痕评价量表(OSAS)评分均明显降低(均P<0.05)。结论:经胸乳入路腔镜甲状腺切除术可以有效地切除甲状腺良性结节,对机体创伤更小,术后并发症较少,手术切口具有良好的美观度,具有临床推广应用价值。

Objective:To observe the clinical effectiveness and cosmetic result of endoscopic thyroidectomy via chest-breast approach in patients with benign thyroid nodules.Methods:From Jan 2015 to Jan 2017,80 patients with benign thyroid nodules in our hospital were selected and randomly divided into a control group and an observation group,with 40 cases in each group.The patients in the control group received conventional open total thyroidectomy,and those in the observation group received endoscopic thyroidectomy via chest-breast approach.The perioperative related indexes,postoperative complications and cosmetic outcomes after one year of operation were compared between the two groups.Results:The operation time and weight of resected masses were similar in the two groups(P>0.05).The intraoperative blood-loss volume,the VAS score at 24 h post-operation,amount of drainage,hospital days,the incidence of complications and the scores of vancouver scar assessment scale(VSS),patient’s scar assessment scale(PSAS)and observer’s scar assessment scale(OSAS)after one year of operation in the observation group were lower than those in the control group(P<0.05).Conclusion:Endoscopic thyroidectomy via chest-breast approach was effective in the treatment of benign thyroid nodules.It had the advantages of less surgical trauma,fewer complications,and better cosmetic results.