经口腔前庭入路与全乳晕入路腔镜单侧良性肿瘤切除术的比较研究

A Comparative Study of Endoscopic Unilateral Benign Tumor Resection Through Oral Vestibular Approach and Full Areola Approach

目的比较经口腔前庭入路与全乳晕入路腔镜单侧良性肿瘤切除术临床效果。方法回顾性分析2017年9月~2020年9月本院普外科行腔镜甲状腺手术的145例单侧良性甲状腺肿瘤患者的临床资料,其中经口腔前庭入路腔镜甲状腺切除术68例设为口腔前庭组,全乳晕入路腔镜甲状腺切除术77例设为全乳晕组,比较两组手术时间、术中出血量、术后总引流量、术后第1天疼痛评分、住院费用、住院时间、术后满意度评分及术后并发症(喉返神经损伤、低钙血症、术后出血、创面感染)发生情况。结果两组手术时间、术中出血量、住院费用、术后并发症发生率比较,差异无统计学意义(P>0.05);口腔前庭组患者术后总引流量、术后第1天疼痛评分及住院时间少于全乳晕组,差异有统计学意义(P<0.05);口腔前庭组满意度评分高于全乳晕组,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切除术在术后总引流量、术后第1天疼痛评分及住院时间方面优于全乳晕入路腔镜甲状腺切除术,且不会增加住院费用,手术安全可行,美容效果好,满意度评分较高。

Objective To compare the clinical effects of endoscopic unilateral benign tumor resection through oral vestibular approach and full areola approach.Methods The clinical data of 145 patients with unilateral benign thyroid tumors who underwent endoscopic thyroid surgery from September 2017 to September 2020 in our hospital were retrospectively analyzed.Among them,68 cases of endoscopic thyroidectomy through oral vestibular approach were set as the oral vestibular group,and 77 cases with total areola approach laparoscopic thyroidectomy were set as the total areola group.The operation time,intraoperative blood loss,and total postoperative total were compared between the two groups.The number of cases of drainage,pain score on the first postoperative day,hospitalization cost,length of stay,postoperative satisfaction score,and postoperative complications(recurrent laryngeal nerve injury,hypocalcemia,postoperative bleeding,wound infection).Results There was no statistically significant difference between the two groups in operation time,intraoperative blood loss,hospitalization expenses,and postoperative complication rate(P>0.05);The total drainage,pain score and hospitalization time on the first day after the operation of the oral vestibule group were less than those of the full areola group,the difference was statistically significant(P<0.05);The satisfaction score of the oral vestibular group was higher than that of the full areola group,the difference was statistically significant(P<0.05).Conclusion Laparoscopic thyroidectomy via oral vestibular approach is superior to total areola approach in terms of total drainage,pain score on the first postoperative day and length of hospital stay,and does not increase hospitalization costs.The operation is safe and feasible,the cosmetic effect is good,and the satisfaction score is high.