经口腔前庭入路腔镜甲状腺手术治疗女性低危甲状腺微小乳头状癌的临床效果

Clinical effect of transoral endoscopic thyroidectomy vestibular approach in the treatment of low-risk papillary thyroid microcarcinoma in women

目的探讨经口腔前庭入路腔镜甲状腺手术治疗女性低危甲状腺微小乳头状癌(PTMC)的临床效果。方法选取2020年11月至2022年1月甘肃省肿瘤医院头颈二科收治的60例女性低危PTMC患者作为研究对象。按照手术方式分为实验组(n=30)和对照组(n=30)。实验组采用经口腔前庭入路腔镜甲状腺手术,对照组采用开放手术。所有患者均行单侧腺叶切除和颈前中央区淋巴结清扫术。比较两组的手术指标、并发症、美容效果及满意度评分。结果实验组手术时间长于对照组,术后引流量多于对照组,移植下位甲状旁腺例数多于对照组,差异有统计学意义(P<0.05)。两组其他各项手术指标比较,差异无统计学意义(P>0.05)。实验组的美容效果及满意度评分高于对照组(P<0.01)。结论经口腔前庭入路腔镜甲状腺手术的优点为美容效果好,治疗的有效性和彻底性与开放手术比较无明显差异,安全性逊于开放手术。该手术方式虽为女性低危PTMC患者提供了一种美观兼顾治疗效果的选择,但应由经验丰富的医生进行操作。

Objective To explore the clinical effect of transoral endoscopic thyroidectomy vestibular approach in the treatment of low-risk papillary thyroid microcarcinoma(PTMC)in women.Methods A total of 60 women with low-risk PTMC admitted to the Second Department of Head and Neck Surgery,Gansu Provincial Cancer Hospital from November 2020 to January 2022 were s elected as the s tudy subjects.They were divided into experimental group(n=30)and control group(n=30)according to different surgical methods.The experimental group was treated with transoral endoscopic thyroidectomy vestibular approach,while the control group was treated with open thyroid surgery.All patients underwent unilateral lobectomy and lymph node dissection in the anterior central region of the neck.The operation indexes,complications,cosmetic effects and satisfaction score were compared between the two groups.Results The operation time of the experimental group was longer than that of the control group,the postoperative drainage volume was more than that of the control group,and the number of transplanted inferior parathyroid glands was more than that of the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in other surgical indexes between the two groups(P>0.05).The cosmetic effect and satisfaction scores of the experimental group were higher than those of the control group(P<0.01).Conclusion The advantages of transoral endoscopic thyroidectomy vestibular approach are cosmetic effect,therapeutic effectiveness and completeness are not significantly different from open thyroid surgery,but the safety of surgery is the disadvantage of this operation.Therefore,although this surgical method provides a aesthetic and therapeutic choice for women with low-risk PTMC,it should be operated by experienced doctors.