免充气经腋窝入路腔镜下甲状腺微小乳头状癌手术疗效评价

Effect evaluation of endoscopic surgery for papillary thyroid microcarcinoma through axillary approach without inflation

目的:探讨免充气经腋窝入路治疗甲状腺微小乳头状癌的手术经验及疗效。方法:选取80例甲状腺微小乳头状癌病人,其中行腔镜手术35例(腔镜组),开放手术45例(开放组),比较2组病人围手术期资料、并发症及随访情况等资料。结果:腔镜组平均年龄较开放组年轻(P<0.05);腔镜组平均手术时间及术后第1天引流液量均较开放组多(P<0.01);腔镜组术中出血量比开放组少(P<0.01);术后第3天颈部VAS评分腔镜组较开放组低(P<0.05);中央区清扫后平均淋巴结数目腔镜组与开放组比较差异无统计学意义(P>0.05);2组病人术后住院时间、术后并发症比较差异无统计学意义(P>0.05);腔镜组术后美容满意度较高(P<0.01);随访3个月以上,均未见复发与转移。结论:免充气经腋窝入路腔镜下甲状腺微小乳头状癌手术安全可行,与开放手术相当,并具有较佳的美容效果。

Objective:To explore the surgical experience and curative effects of the axillary approach without inflation in the treatment of papillary thyroid microcarcinoma.Methods:A total of 80 patients with papillary thyroid microcarcinoma were divided into the endoscope group(35 cases treated with endoscopic surgery)and open group(45 cases treated with open surgery).The perioperative data,complications and following-up data were compared between two groups.Results:The average age in endoscope group was younger than that in open group(P<0.05),the average operation time and amount of drainage fluid on the first day after the operation in endoscope group were more than those in open group(P<0.01),and the intraoperative blood loss in endoscope group was less than that in open group(P<0.01).The neck VAS score in endoscope group was lower than that in open group on the third day after operation(P<0.05).The difference of the average number of lymph nodes after central dissection between two groups was not statistically significant(P>0.05).There was no statistical significance in the postoperative hospital stay and postoperative complications between two groups(P>0.05).The postoperative cosmetic satisfaction in endoscope group was higher than that in open group(P<0.01).All cases were followed up for more than 3 months,and no recurrence or metastasis case was found.Conclusions:The axillary approach without inflation in the treatment of papillary thyroid microcarcinoma is safe and feasible,has better cosmetic effects,and which is comparable to open surgery.