腔镜下经胸-乳入路甲状腺癌根治术与传统开放手术治疗cN0期甲状腺乳头状癌的疗效观察

The efficacy of endoscopic radical thyroidectomy via breast areola approach and conventional open surgery in the treatment of cN0 stage papillary thyroid carcinoma

目的探讨腔镜下经胸-乳入路甲状腺癌根治术与传统开放手术治疗cN0期甲状腺乳头状癌(PTC)的疗效。方法手术治疗的60例cN0期PTC患者,按照手术方式分为腔镜组(腔镜下经胸-乳入路甲状腺癌根治术)和开放组(传统开放手术)各30例。比较两组手术情况、手术疗效、术后1d视觉模拟(VAS)评分、术后3个月Vancouver疤痕评定量表(VSS)评分及术后并发症情况。结果腔镜组手术时间长于开放组,术中出血量少于开放组,切口长度小于开放组,总有效率高于开放组,VAS评分、VSS评分、术后并发症发生率低于对照组(P<0.05)。结论与传统开放手术比较,腔镜下经胸-乳入路甲状腺癌根治术治疗cN0期PTC的临床应用价值更高,可减轻患者术后疼痛,美容效果满意,提高手术安全性。

Objective To observe the efficacy of endoscopic radical thyroidectomy via breast areola approach and conventional open surgery in the treatment of cN0 stage papillary thyroid carcinoma(PTC).Methods Sixty cN0 stage PTC patients who underwent surgery in our hospitals were divided into laparoscopic group(endoscopic radical thyroidectomy via breast areola approach)and open group(conventional open surgery)according to the surgical procedures,30 in each group.The operation status,surgical efficacy,visual analogue scale(VAS)score after one day of surgery,Vancouver scar scale(VSS)score after 3 months of surgery and postoperative complications were recorded and compared between the two groups.Results The operative time was longer,the intraoperative blood loss was less,the incision length was smaller,the total effective rate of surgical efficacy was higher,the VAS and VSS scores were lower and the incidence rate of postoperative complications was lower in the laparoscopic group than those in the control group(all P<0.05).Conclusion Compared with conventional open surgery,endoscopic radical thyroidectomy via breast areola approach has a higher clinical value in the treatment of cN0 stage PTC.This is because it can reduce the postoperative pain and have satisfactory cosmetic results and improve the surgical safety.