腋窝入路腔镜甲状腺癌切除术的疗效及安全性

Efficacy and safety of transaxillary laparoscopic thyroidectomy

目的分析腋窝入路腔镜甲状腺癌切除术的疗效及安全性。方法抽取郑州大学附属郑州中心医院2017年5月至2018年5月收治的甲状腺癌患者60例为研究对象,依据手术方案将其分为观察组和对照组,每组30例。观察组行腋窝入路腔镜甲状腺癌切除术,对照组行传统开放式甲状腺癌切除术,比较两组术后疼痛评分、围术期指标、淋巴清扫情况、并发症及复发情况。结果观察组术中出血量小于对照组,手术时间、术后引流量大于对照组(P<0.05);两组术后住院时间、引流管留置时间比较差异未见统计学意义(P>0.05);两组淋巴结清扫数、甲状旁腺误切率、术后低血钙病例比较差异未见统计学意义(P>0.05);观察组术后第1、2天疼痛评分低于对照组(P<0.05);两组术后第5天疼痛评分比较差异未见统计学意义(P>0.05);两组术后并发症发生率及复发率比较差异未见统计学意义(P>0.05)。结论腋窝入路腔镜甲状腺癌切除术与传统开放甲状腺根治术相比,疗效显著,能够有效缓解患者术后疼痛,且术后并发症及复发率较低。

Objective To analyze the efficacy and safety of transaxillary laparoscopic thyroidectomy.Methods Sixty patients with thyroid cancer admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from May 2017 to May 2018 were enrolled, and they were divided into two groups according to the surgical plans, with 30 cases in each group. The observation group underwent transaxillary laparoscopic thyroidectomy, while the control group underwent traditional open thyroidectomy. Perioperative indicators, lymph node dissection, postoperative pain score, complications and recurrence were compared between the two groups.Results The intraoperative blood loss, operation time and postoperative drainage volume in the observation group were significantly better than those in the control group (P<0.05), while no difference was found in the postoperative hospital stay and indwelling time between the two groups (P>0.05). The number of lymph node dissection, rate of parathyroidectomy, and postoperative hypocalcemia cases showed no difference between the two groups (P>0.05). The pain scores at the postoperative 1 d and 2 d were lower in the observation group than those in the control group (P<0.05), and no difference was found between the two groups in the pain scores at the postoperative 5 d (P>0.05). There was no significant difference in the incidence of postoperative complications and recurrence rate between the two groups (P>0.05).Conclusions Compared with the traditional open radical thyroidectomy, application of transaxillary laparoscopic thyroidectomy can reduce intraoperative blood loss and relieve postoperative pain for patients with thyroid cancer, with lower rates of postoperative complications and recurrence.