改良Miccoli腔镜辅助颈侧区清扫术治疗分化型甲状腺癌患者的临床效果

Clinical Effect of Modified Miccoli Endoscope Assisted Neck Lateral Dissection in the Treatment of Patients with Differentiated Thyroid Cancer

目的:研究改良Miccoli腔镜辅助颈侧区清扫术治疗分化型甲状腺癌(DTC)患者的临床效果。方法:选取2018年1月-2021年1月68例DTC患者作为研究对象,依据患者挂号单双数均等分为观察组(n=34)和对照组(n=34)。观察组采用改良Miccoli腔镜辅助颈侧区清扫术,对照组采用传统开放式颈淋巴结清扫术。比较两组患者淋巴结清扫数量、手术时间、住院时间、术中出血量、瘢痕长度及术后并发症发生率。结果:两组淋巴结清扫数量、手术时间、住院时间、切口愈合不良和喉返神经损伤发生率比较差异均无统计学意义(P>0.05);观察组术中出血量少于对照组,瘢痕长度短于对照组(P<0.05),观察组术后低钙血症、喉上神经损伤和甲旁减发生率均低于对照组(P<0.05)。结论:改良Miccoli腔镜辅助颈侧区清扫术与传统开放式颈淋巴结清扫术在DTC患者的治疗中均具有良好的淋巴结清扫效果,但改良Miccoli腔镜辅助颈侧区清扫术对患者损伤较小,美观效果更佳,术后并发症发生率更低,临床应用价值较高。

Objective:To study the clinical effect of modified Miccoli endoscope assisted neck lateral dissection in the treatment of differentiated thyroid cancer (DTC).Method:A total of 68 DTC patients from January 2018 to January 2021 were selected as research subjects and they were divided into observation group (n=34) and control group (n=34) according to the odd or even number of registered patients.The observation group was performed with modified Miccoli endoscopy assisted neck lateral dissection,while the control group was performed with traditional open cervical lymph node dissection.The number of lymph node dissection,operation time,hospital stay,intraoperative blood loss,scar length and incidence of postoperative complications were compared between the two groups.Result:There were no significant differences in the number of lymph node dissection,operation time,hospital stay,the incidences of poor wound healing and recurrent laryngeal nerve injury between the two groups (P>0.05);the intraoperative blood loss in the observation group was less than that in the control group,and the length of scar was shorter than that in the control group (P<0.05).The incidences of postoperative hypocalcemia,superior laryngeal nerve injury and hypothyroidism in the observation group were lower than those in the control group (P<0.05).Conclusion:Both the modified Miccoli endoscopic assisted neck lateral dissection and the traditional open cervical lymph node dissection have good lymph node dissection effect in the treatment of DTC patients,but the modified Miccoli endoscopic assisted neck lateral dissection has less damage,better aesthetic effect,lower incidence of postoperative complications and higher clinical application value.