经腋窝入路与乳晕入路腔镜甲状腺癌根治术的疗效及美学效果观察

Efficacy and Aesthetic Effect of Endoscopic Thyroidectomy through the Axillary Approach and the Areola Approach in the Treatment of Thyroid Cancer

目的探讨经腋窝入路与乳晕入路腔镜甲状腺癌根治术治疗甲状腺癌的疗效及对美学效果的影响。方法采用前瞻性随机对照研究,选取2020年9月~2022年9月在湖南中医药大学第一附属医院行甲状腺癌切除术的88例甲状腺癌患者,按随机数字表法分为观察组(经腋窝入路腔镜甲状腺癌根治术,44例)与对照组(全乳晕入路腔镜甲状腺癌根治术,44例)。比较两组手术时间、术中出血量、术后引流量、术后拔管时间、住院时间、术后温哥华瘢痕量表(Vancouver scar scale,VSS)评分、术后并发症及淋巴结清除数。结果观察组手术时间、术中出血量、术后引流量显著少于对照组(P<0.05);观察组术后VSS各项评分及总分均显著低于对照组(P<0.05);两组术后并发症总发生率及淋巴结清除数比较均无统计学差异(P>0.05)。结论与乳晕入路相比,经腋窝入路腔镜甲状腺癌切除术的手术效果及美容效果更好。

Objective To investigate the efficacy and aesthetic effect of endoscopic thyroidectomy through the axillary approach and the areola approach in the treatment of thyroid cancer.Methods A total of 88 patients with thyroid cancer who underwent thyroidectomy in the First Affiliated Hospital of Hunan University of Chinese Medicine from September 2020 to September 2022 were included in the study.According to the random number table,they were divided into the observation group(endoscopic thyroidectomy through the axillary approach,44 cases)and the control group(endoscopic thyroidectomy through the areolar approach,44 cases).Operation time,intraoperative blood loss,postoperative drainage volume,postoperative extubation time,hospital stay,postoperative Vancouver scar scale(VSS),postoperative complications and lymph node of clearance were compared between the two groups.Results Operation time,intraoperative blood loss and postoperative drainage volume in the observation group were significantly lower than those in the control group(P<0.05).Postoperative VSS index and total VSS score of the observation group was significantly lower than that of the control group(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).There was no significant difference in lymph node clearance between the two approaches(P>0.05).Conclusion Compared with the areola approach,endoscopic thyroidectomy through the axillary approach has better surgical and cosmetic effects for thyroid cancer patients.