经口腔前庭入路与胸乳入路腔镜单侧甲状腺微小癌手术的临床疗效比较

Comparison of the clinical efficacy of endoscopic thyroidectomy via vestibular approach and endoscopic thyroidectomy via breast approach of unilateral thyroid microcarcinoma

目的对比研究经口腔前庭入路与胸乳入路腔镜单侧甲状腺微小癌手术的临床疗效。方法回顾分析2019年1月至2020年12月安徽医科大学附属安庆医院40例腔镜单侧甲状腺微小癌手术女性病人的临床资料,按照手术入路不同分为两组,分别为经口腔前庭入路组(观察组,n=20)及经胸乳入路组(对照组,n=20),对比研究两组术中、术后相关情况。结果观察组与对照组在手术时间[(135.25±7.52)min比(131.50±8.13)min]、手术中出血量[(24.00±6.61)mL比(25.50±6.05)mL]、住院时间[(8.75±2.17)d比(9.40±1.50)d]、术后甲状旁腺素(PTH)值[(50.75±7.48)ng/L比(49.00±7.53)ng/L]、中央区淋巴结清扫数量[(8.05±0.89)个比(7.55±0.83)个]差异无统计学意义(P>0.05),两组总并发症发生率差异无统计学意义(P>0.05),观察组术后美容满意度评分[(9.20±0.77)分比(7.85±0.67)分]及生活质量评分[(92.40±6.32)分比(81.10±5.58)分]均高于对照组(P<0.05)。结论经口腔前庭入路较胸乳入路腔镜单侧甲状腺微小癌手术美容效果好,并发症无差别,安全可靠,更能满足对手术美容效果要求高的病人,值得推广。

Objective To compare the clinical efficacy of endoscopic thyroidectomy via vestibular approach and endoscopic thyroid-ectomy via breast approach of unilateral thyroid microcarcinoma.Methods The clinical data of 40 female patients undergoing endo-scopic unilateral thyroid microcarcinoma surgery in Anqing Hospital affiliated to Anhui Medical University from January 2019 to De-cember 2020 were retrospectively analyzed.According to the surgical method,they were randomly assigned into the endoscopic thyroid-ectomy via vestibular approach group(observation group,n=20)and endoscopic thyroidectomy via breast approach group(control group,n=20),the intraoperative and postoperative data between the two groups were compared.Results There were no obvious differ-ences between the observation group and the control group in the operation time[(135.25±7.52)min vs.(131.50±8.13)min],blood loss during operation[(24.00±6.61)mL vs.(25.50±6.05)mL],hospitalization time[(8.75±2.17)day vs.(9.40±1.50)day],postoperative para-thyroid hormone value[(50.75±7.48)ng/L vs.(49.00±7.53)ng/L],and the number of central lymph node dissections[(8.05±0.89)num-ber vs.(7.55±0.83)number](P>0.05).There were no obvious differences in the total complication rate between the two groups(P>0.05).Postoperative beauty satisfaction score[(9.20±0.77)point vs.(7.85±0.67)point]and quality of life score[(92.40±6.32)point vs.(81.10±5.58)point]in the observation group were higher than those in the control group(P<0.05).Conclusions Endoscopic thyroidectomy via vestibular approach has better cosmetic effect than endoscopic thyroidectomy via breast approach,with no difference in complications,safety and reliability.It is more suitable for patients with high requirements for cosmetic effect of surgery,and worthy of promotion.