全腔镜手术治疗甲状腺微小乳头状癌的疗效分析

Effects of totally endoscopic thyroidectomy for papillary thyroid microcarcinoma

目的探讨全腔镜手术方式在治疗甲状腺微小乳头状癌(PTMC)中的临床价值。方法回顾分析2015年10月至2018年6月期间40例PTMC患者的临床资料和随访资料。其中全腔镜途径手术20例(腔镜组),传统开放途径手术20例(开放组)。应用SPSS 17.0统计软件对数据进行处理。术中术后计量资料以均数±标准差表示,采用独立t检验。术后并发症、颈部舒适度、复发及转移等组间比较采用χ^2检验及Fisher精确检验,P<0.05为差异有统计学意义。结果腔镜组手术时间和平均住院日明显大于开放组(P<0.05);两组患者术后并发症、淋巴结清扫数量比较差异无统计学意义(P>0.05);腔镜组术后颈部舒适感明显强于开放组(P>0.05);所有患者随访中均未发现肿瘤复发和转移征象。结论全腔镜手术在治疗早期分化型甲状腺癌尤其甲状腺微小乳头状癌中能达到开放手术相似的根治度,不影响患者的预后,且能够满足患者(尤其是女性)对美容的需求,值得临床开展。

Objective To investigate the clinical value of totally endoscopic thyroidectomy in treating papillary thyroid microcarcinoma(PTMC).Methods The clinical data and follow-up data of 40 patients with PTMC were retrospectively analyzed from October 2015 to June 2018.They were divided into two groups,20 patients with totally endoscopic thyroidectomy(group A),20 patients with conventional open thyroidectomy(group B).SPSS 17.0 was used to process data.The quantitative data were expressed in(±s),compared with t test.χ^2 test and Fisher exact test were used to compare postoperative complications、neck comfort、recurrence and metastasis and so on between two groups,the difference was statistically significant if P<0.05.Results The operative time and average hospital stay in group A were significantly longer than group B(P<0.05);There were no significant difference in postoperative complications、number of the lymph node dissection between the two groups.Neck comfort in group A was significantly better than group B;During the follow-up,there were no tumor recurrence or metastasis in all patients.Conclusion The totally endoscopic thyroidectomy in treating early-stage differentiated thyroid carcinoma(DTC)especially in PTMC may achieve a similar curative effect compare with open group.It does not affect the prognosis of patients,and could meet the cosmetology of patients especially for women.It is worth for clinical development.