经口腔入路甲状腺腔镜手术在治疗甲状腺微小癌的应用价值及美容性效果

Application Value and Cosmetic Results of Transoral Endoscopic Thyroidectomy for the Treatment of Thyroid Microcarcinoma

目的对比研究经口腔前庭入路腔镜甲状腺手术与传统甲状腺开放手术治疗甲状腺微小乳头状癌的应用价值和可行性。方法随机选取2018年11月至2019年8月在昆明医科大学第三附属医院(云南省肿瘤医院)治疗的40例甲状腺微小癌患者,依据患者的个人意愿,20例行经口腔前庭入路腔镜甲状腺切除术(腔镜组);20例行传统甲状腺开放手术(对照组)。记录并比较两组术中出血量、手术时间、住院时间、术后引流量、美观满意度及术后并发症发生率。结果腔镜组腔镜甲状腺癌根治术均成功完成,术后无明显并发症。两组在术后引流量、术后复发情况、术后6个月咽部吞咽不适感比较,差异无统计学意义(P> 0.05)。而在手术时间,患者美容满意度差异有统计学意义(P <0.05)。结论经口腔前庭入路腔镜甲状腺癌根治术安全有效,颈部无疤痕、对于有美容需求的患者是一种良好的选择。

Objective To compare the clinical application value and feasibility of transoral vestibular endoscopic thyroidectomy for the treatment of microthyroid papillary carcinoma. Methods 40 patients with minimal thyroid tumors treated at the Third Affiliated Hospital of Kunming Medical University(Yunnan Tumor Hospital) from November 2018 to August 2019 were selected and divided into ETOVA group and the control group according to the patients’ wishes. At ETOVA group, 20 patients were treated by trans-oral endoscopic thyroidectomy via oral vestibular approach. And 20 patients were treated by conventional radical thyroidectomy in the control group. The operative time,intraoperative blood loss,postoperative drainage,length of hospital stay,incidence of postoperative complications, and aesthetic satisfaction were compared between the two groups.Results In the ETOVA group,endoscopic radical thyroid tumor resection was successfully completed, and there were no obvious complications during the perioperative period. There was no significant difference between the two groups on the first day of postoperative drainage,postoperative recurrence,and pharyngeal discomfort at 6 months after the operation(P > 0.05). The difference on the operation time and aesthetic satisfaction was statistically significant(P < 0.05). Conclusion Compared with conventional radical thyroidectomy,the trans-oral endoscopic thyroidectomy is safe and reliable, and it has advantages in concealed incisions and rapid postoperative recovery.