经口腔前庭入路腔镜下甲状腺癌根治术与传统开放手术的疗效比较

Comparison of the clinical effects on thyroid cancer between transoral endoscopic thyroidectomy via vestibular approach and open surgery

目的比较经口腔前庭入路腔镜下甲状腺癌根治术与传统开放手术的疗效。方法将该院2019-01~2020-01收治的50例早期甲状腺乳头状癌患者按手术方式分为腔镜组(n=22)和开放组(n=28)。腔镜组采取经口腔前庭入路腔镜下甲状腺癌根治术,开放组行传统开放手术。比较两组手术时间、术中出血量、术后引流量、美容满意度评分及术后并发症等情况。结果腔镜组手术时间、术后引流量均长于或多于开放组(P均<0.05),腔镜组术后视觉模拟量表(Visual Analogue Scale,VAS)评分低于开放组、美容满意度评分高于开放组(P均<0.05)。但两组术中出血量、住院时间、淋巴结清扫数量比较差异均无统计学意义(P>0.05)。两组均未出现永久性声嘶、血肿、永久性甲状旁腺功能减退,腔镜组1例出现感染,开放组1例出现积液。结论经口腔前庭入路腔镜下甲状腺癌根治术是安全、可行、有效的手术方式,且美容效果好,值得临床推广。

Objective To compare the clinical effects on thyroid cancer between transoral endoscopic thyroidectomy via vestibular approach(TOETVA)and open surgery.Methods Fifty patients with early papillary thyroid carcinoma treated in our hospital from January 2019 to January 2020 were divided into the endoscopy group(n=22)and the open group(n=28)according to different treatment methods.The endoscopy group underwent TOETVA for thyroid cancer,while the open group underwent traditional open surgery.The operative time,intraoperative blood loss,postoperative drainage volume,cosmetic scores and postoperative complications were compared between the two groups.Results The operative time in the endoscopy group was significantly longer than that in the open group(P<0.05).The postoperative drainage volume in the endoscopy group was significantly larger than that in the open group(P<0.05).After operation,the Visual Analogue Scale(VAS)scores of the endoscopy group were significantly lower than those of the open group(P<0.05),and the scores of aesthetic satisfaction in the endoscopy group were significantly higher than those in the open group(P<0.05).However,there were no significant differences in the intraoperative blood loss,the length of hospital stay and the number of lymph nodes dissected between the two groups(P>0.05).There were no cases with permanent hoarseness,hematoma and permanent hypoparathyroidism in the two groups.One case in the endoscopy group had infection and one case in the open group had effusion.Conclusion TOETVA is a safe,feasible and effective surgical method for radical thyroidectomy of thyroid cancer.It has a good cosmetic effect and is worthy of clinical promotion.