经腋窝入路免充气腔镜下行甲状腺癌根治术的疗效及安全性评价

Efficacy and Safety Evaluation of Air-free Endoscopic Radical Thyroidectomy via Axillary Approach

目的探讨经腋窝入路免充气腔镜下甲状腺癌根治术的疗效及安全性。方法根据手术方式将115例单侧甲状腺癌患者分为观察组与对照组,其中观察组54例,接受经腋窝入路免充气腔镜下甲状腺癌根治术治疗,对照组61例,接受颈前切口开放手术治疗。结果⑴观察组术中出血量显著少于对照组,手术时间、术后住院时间显著长于对照组,术后引流量显著高于对照组,差异有统计学意义(P<0.05)。两组患者中央区清扫淋巴结数比较差异无统计学意义(P>0.05)。⑵术后第3天,观察组颈部疼痛评分显著低于对照组,差异有统计学意义(P<0.05)。两组患者颈部损伤指数比较差异无统计学意义(P>0.05)。⑶两组患者呼吸困难、吞咽困难、声音嘶哑、皮下血肿等并发症发生率比较差异无统计学意义(P>0.05)。⑷术后3个月,观察组美容满意度显著高于对照组,差异有统计学意义(P<0.05)。结论经腋窝入路免充气腔镜下甲状腺癌根治术的疗效及安全性良好,且同时具有痛感轻、美容满意度佳等优点。

Objective To explore the efficacy and safety of air-free endoscopic radical thyroidectomy via axillary approach.Methods According to the operation method,115 patients with unilateral thyroid cancer were divided into the observation group and the control group,and the observation group including 54 cases who received air-free endoscopic radical thyroidectomy via axillary approach,while the control group including 61 cases who received open operation via anterior cervical incision.Results⑴The intraoperative blood loss in observation group was significantly lower than that of the control group,while the operation time,postoperative hospital stay and postoperative drainage volume in the observation group were significantly higher than those of the control group(P<0.05).There was no significant difference in the number of lymph nodes cleared in central area between the 2 groups(P>0.05).⑵On the 3rd day after operation,the neck pain scores in the observation group were significantly lower than those of the control group(P<0.05).There was no significant difference in the neck injury index between the 2 groups(P>0.05).⑶There were no significant differences in the incidences of dyspnea,dysphagia,hoarseness and subcutaneous hematoma between the 2 groups(P>0.05).⑷At the end of 3rd month after operation,the beauty satisfaction of the observation group was significantly better than that of the control group(P<0.05).Conclusion The air-free endoscopic radical thyroidectomy via axillary approach shows good efficacy and safety,and it also has the advantages of light pain and good cosmetic satisfaction.