经口腔镜下甲状腺癌切除术的疗效及美学效果分析

Analysis of the Curative Effect and Cosmetic Effect of Transoral Endoscopic Resection of Thyroid Cancer

目的:探究对比经口联合入路腔镜甲状腺癌切除与传统手术治疗甲状腺癌的疗效。方法:回顾性分析2020年1月-2021年1月在笔者医院行手术治疗的甲状腺癌患者148例,依据手术方式分为腔镜组(n=45,经口腔前庭入路腔镜下甲状腺癌切除术)和开放组(n=103,传统开放手术),分析两组患者临床疗效、手术前后血清白介素-6(IL-6)和肿瘤坏死因子(TNF-α)表达水平、声音障碍评分、切口美学效果评分以及术后并发症发生率的差异性。结果:术后腔镜组缓解率明显高于开放组,差异有统计学意义(P<0.05)。术后3 d,两组患者的IL-6、TNF-α水平均较术前明显上升,且开放组较腔镜组上升更明显(P<0.05)。术后1个月,两组声音障碍评分均较术前明显降低,且腔镜组降低更明显(P<0.05)。腔镜组患者的温哥华瘢痕量表各分项及总评分均低于开放组(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:与传统开放手术比较,经口腔前庭入路腔镜下甲状腺癌切除术治疗甲状腺癌疗效显著,具有外观无创、有效改善患者术后声音嘶哑等功能及美学效果俱佳的效果,对于临床诊治借鉴意义较大。

Objective This research aims to compare the curative effect of transoral endoscopic resection of thyroid cancer and traditional surgery in the treatment of thyroid cancer.Methods This study retrospectively analyzed 148 patients with thyroid cancer who underwent surgical treatment in our hospital from January 2020 to January 2021.According to the surgical method,patients enrolled were divided into the endoscopic group(n=45,resection of thyroid cancer via transoral vestibular approach)and open group(n=103,traditional open surgery).Clinical efficacy,expression levels of serum interleukin-6(IL-6)and tumor necrosis factor(TNF-α)before and after surgery,voice disturbance score,and incision cosmetic effect scores and the incidence rates of postoperative complications in the two groups were analyzed.Results The postoperative remission rate of the endoscopic group was significantly higher than that of the open group,and the difference was statistically significant(P<0.05).On the 3rd day after operation,the levels of IL-6 and TNF-αin the two groups were significantly increased compared with those before operation,and the increase in the open group was more obvious than that in the endoscopic group(P<0.05).One month after operation,the voice disturbance scores in both groups were significantly lower than those before operation,and the reduction was more obvious in the endoscopic group(P<0.05).The scores of different items in the Vancouver Scar Scale and the total score were lower in the endoscopic group than in the open group(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with traditional open surgery,transoral endoscopic resection of thyroid cancer is more effective in the treatment of thyroid cancer.Besides,it is noninvasive and can effectively improve hoarseness after surgery while achieving better cosmetic effect,which is of greater significance for clinical diagnosis and treatment.