经胸乳入路腔镜手术治疗女性单侧甲状腺微小乳头状癌的临床价值

The clinical value of laparoscopic operation in thoracic breast approach for unilateral papillary thyroid microcarcinoma of females

目的:探讨经胸乳入路腔镜技术在女性单侧甲状腺微小乳头状癌手术中的应用价值。方法:回顾分析2019年1月至2020年7月收治的50例女性甲状腺微小乳头状癌患者的临床资料,根据术式分为腔镜组(n=25)与开放组(n=25)。对比分析两组手术时间、中央区淋巴结清扫数量、术后引流量、置管时间、术后美容效果、术后并发症等。结果:两组中央区淋巴结清扫数量、术后引流量、置管时间、术后并发症发生率差异无统计学意义(P>0.05);腔镜组手术时间长于开放组,患者对切口满意度更高,两组差异有统计学意义(P<0.05)。结论:全腔镜技术与开放甲状腺手术在甲状腺微小乳头状癌根治术中的疗效相当,但腔镜手术美容效果更好,对美容要求高且颈侧无肿大淋巴结的甲状腺微小乳头状癌患者可作为首选术式。

Objective:To investigate the value of the thoracic breast access endoscopic technique in the surgery of unilateral papillary thyroid microcarcinoma of females.Methods:The clinical data of 50 female patients with papillary thyroid microcarcinoma from Jan.2019 to Jul.2020 were retrospectively analyzed.They were divided into endoscopic group(25 cases)and open group(25 cases)according to different surgical procedures.Statistical data such as operative time,number of lymph node harvested in the central region,postoperative drainage,tube placement time,postoperative cosmetic effect and postoperative complications were analyzed and compared between the two groups.Results:The differences between the two groups in the number of central lymph node dissection,postoperative drainage,drainage tube placement time and postoperative complications were not statistically significant(P>0.05),the operative time was longer and incision satisfaction was higher in the endoscopic group than those in the open group(P<0.05).Conclusions:Compared with thyroid open radical surgery in the treatment of papillary microcarcinoma,totally endoscopic technique has comparable therapeutic effects and better postoperative cosmetic results,and can be the first choice for papillary thyroid microcarcinoma patients with high cosmetic requirements and no enlarged lymph nodes in the lateral neck.