完全腔镜辅助下甲状腺癌根治术对甲状腺激素及外周血循环肿瘤细胞的影响

Effect of Radical Thyroidectomy Assisted by Complete Endoscopy on Thyroid Hormone and Peripheral Blood Circulating Tumor Cells

目的:探究与分析完全腔镜辅助下甲状腺癌根治术的效果,与常规手术对比,以期获得最好的效果。方法:回顾性分析本院2018年5月-2020年4月收治的甲状腺癌患者108例的临床资料,按照不同手术治疗方法分为常规手术组(n=60)与完全腔镜组(n=48),对比两组围术期指标、术后并发症发生率、手术治疗前后甲状腺激素相关指标及外周血肿瘤细胞水平、随访结果。结果:完全腔镜组与常规手术组相比,手术时间长、切口长度短、住院天数短、术后第2天引流量少、术后并发症发生率低,差异有统计学意义(P<0.05)。两组术中出血量及中央区淋巴结清扫个数差异无统计学意义(P>0.05)。两组术后与术前相比T_(3)、T_(4)、FT_(3)、FT_(4)值均降低,TSH值升高,差异有统计学意义(P<0.05)。但两组术后T_(3)、T_(4)、FT_(3)、FT_(4)及TSH值相比差异无统计学意义(P>0.05)。完全腔镜组术后外周血循环肿瘤细胞与常规手术组相比较少,差异有统计学意义(P<0.05)。两组随访期间均未见肿瘤复发。结论:完全腔镜辅助下甲状腺癌根治术与常规手术相比围术期指标表现更好,术后并发症发生率较低,在降低外周血循环肿瘤细胞水平上更具优势,同时获得了良好的预后随访结局。

Objective:To explore and analyze the effect of radical thyroidectomy assisted by complete endoscopy and compare it with conventional surgery,so as to obtain the best surgical outcome.Method:The clinical data of 108 cases of patients with thyroid cancer in our hospital from May 2018 to April 2020 were retrospective analyzed,according to different operative methods they were divided into the conventional surgery group(n=60)and complete endoscopy group(n=48),two groups of perioperative,postoperative complications,postoperative inflammatory factor levels and follow-up results were compared.Result:Compared with the conventional surgery group,the complete endoscopic group had longer operation time,shorter incision length,shorter hospitalization days,less drainage on the second day after surgery,and the incidence of postoperative complications,with statistically significant differences(P<0.05).There were no significant differences in intraoperative blood loss and number of lymph node dissection in central region between the two groups(P>0.05).The values of T_(3),T_(4),FT_(3) and FT_(4) in the two groups after operation compared with those before operation were all decreased,and the TSH values were increased,with statistically significant differences(P<0.05).However,there were no significant difference in T_(3),T^(4),FT_(3),FT_(4) and TSH between the two groups(P>0.05).There were fewer circulating tumor cells in peripheral blood after surgery in the complete endoscopic group than in the conventional surgery group,and the difference was statistically significant(P<0.05).No tumor recurrence was observed during the follow-up in both groups.Conclusion:Compares with conventional surgery,radical thyroidectomy with complete endoscopy performed better in perioperative indicators,has a lower incidence of postoperative complications,is more advantageous in reducing the level of circulating tumor cells in peripheral blood,and obtains a good prognosis and follow-up outcome.