无充气腋窝入路腔镜在甲状腺手术中临床体会

Clinical experience of endoscopic surgery through non aerated axillary approach in thyroid surgery

目的探讨无充气经腋窝腔镜甲状腺手术的临床效果。方法分析2020年9月至2021年11月本院收治的62例因甲状腺肿瘤而行手术的患者的临床资料。随机分为对照组和实验组各31例。对照组采取传统开放甲状腺手术;实验组采取无充气腋窝入路腔镜甲状腺。观察两组患者的手术时间、术后48h引流量和住院时间。观察术后1个月内的并发症和术后1个月评估切口美容满意度。结果比较两组手术情况。实验组手术时间和住院时间均高于对照组,差异具备统计学意义(P<0.05);而两组术后48h引流量相比较差异不显著(P>0.05)。比较两组患者术后并发症情况,实验组并发症发生率少于对照组,差异具备统计学意义,P<0.05。比较两组患者切口美容满意度,实验组患者对切口满意率高于对照组,差异具备统计学意义,P<0.05。结论无充气经腋窝腔镜甲状腺手术能够减少患者的术后并发症发生率较低,美容效果较好,但是可能会增加手术时间和住院时间,在临床实践中可根据患者需要合理选择手术方案。

Objective To investigate the clinical effect of endoscopic thyroidectomy without inflation.Methods The clinical data of 62 patients with thyroid tumor who underwent surgery in our hospital from September 2020 to November 2021 were analyzed.The patients were randomly divided into control group and experimental group with 31 cases in each group.The patient in the control group was treated with traditional open thyroid surgery,and in the experimental group was treated with endoscopic thyroid surgery through non aerated axillary approach.The operation time,drainage volume at 48 hours after operation and hospital stay were observed.The complications within 1 month after operation and the satisfaction of incision beauty were observed.Results The operation time and hospital stay of the experimental group were significantly higher than those of the control group(P<0.05).There was no significant difference between the two groups at 48 hours after operation(P>0.05).The postoperative complications of the two groups were compared.The incidence of complications in the experimental group was less than that in the control group.The difference was statistically significant(P<0.05).The patients in the experimental group were more satisfied with the incision than those in the control group(P<0.05).Conclusion Non-aerated axillary endoscopic thyroidectomy can reduce the incidence of postoperative complications and has a good cosmetic effect,but it may increase the operation time and hospital stay.In clinical practice,the operation scheme can be reasonably selected according to the needs of patients.