腔镜甲状腺癌根治术与开放手术术后引流情况对比及原因分析

Comparison of drainage after endoscopic thyroidectomy and open surgery and analysis of the causes

目的探讨行甲状腺癌根治术患者采用完全腔镜技术与传统开放技术的术后引流情况对比及相关原因分析。方法90例行单侧甲状腺癌根治术患者,依据手术方式的不同分为腔镜组和开放组,每组45例。腔镜组采用完全腔镜下甲状腺癌根治术治疗,开放组采用传统开放手术治疗。比较两组患者术后引流情况、相关指标及生活质量评分,并展开相关原因分析。结果腔镜组患者的手术时间(100.00±5.00)min、引流时间(4.00±0.50)d及住院时间(7.50±0.50)d均长于开放组的(70.00±3.00)min、(3.00±0.60)d、(5.50±1.00)d,术后引流量(175.00±1.50)ml多于开放组的(103.00±1.00)ml,差异具有统计学意义(P<0.05)。腔镜组患者的术后并发症发生率4.44%(2/45)低于开放组的11.11%(5/45),但差异无统计学意义(P>0.05)。两组患者的神经或甲状旁腺损伤均为暂时性损伤。腔镜组患者的术后生活质量评分为(88.68±2.36)分,高于开放组的(80.35±2.10)分,差异具有统计学意义(t=17.689,P<0.05)。结论甲状腺癌根治术患者采用完全腔镜下甲状腺癌根治术与传统开放手术均能达到一定的治疗效果,传统开放手术在手术用时、术后引流等方面要优于完全腔镜手术,但在术后美容及术后生活质量方面,完全腔镜手术较传统开放手术具有绝对优势。

Objective To discuss the postoperative drainage of totally endoscopic technique and conventional open techniques,and analyze the related reasons.Methods A total of 90 patients with unilateral thyroidectomy were divided into endoscopic group and open group according to different surgical methods,with 45 cases in each group.The endoscopic group was treated with totally endoscopic thyroidectomy,and the open group was treated with conventional open surgery.The postoperative drainage,related indicators,and quality of life score were compared between the two group,and the related reasons were analyzed.Results The endoscopic group had operation time of(100.00±5.00)min,drainage time of(4.00±0.50)d and hospitalization time of(7.50±0.50)d,which were longer than(70.00±3.00)min,(3.00±0.60)d and(5.50±1.00)d in the open group;the postoperative drainage volume of the endoscopic group was(175.00±1.50)ml,which was greater than(103.00±1.00)ml in the open group;the differences were statistically significant(P<0.05).The incidence of postoperative complications in the endoscopic group was 4.44%(2/45),which was lower than 11.11%(5/45)in the open group,and the difference was statistically significant(P>0.05).Patients in both groups had temporary nerve or parathyroid injury.The postoperative quality of life score in the endoscopic group was(88.68±2.36)points,which was higher than(80.35±2.10)points in the open group,and the difference was statistically significant(t=17.689,P<0.05).Conclusion For patients with radical thyroidectomy,both totally endoscopic thyroidectomy and conventional open surgery can achieve a certain therapeutic effect;conventional open surgery is better than totally endoscopic thyroidectomy in terms of operation time and postoperative drainage,but totally endoscopic surgery has absolute advantages over conventional open surgery in terms of postoperative cosmetic and postoperative quality of life.