无充气腋窝入路和胸乳入路腔镜甲状腺手术的效果比较

Comparison of the effect of transaxillay gasless endoscopic thyroidectomy and endoscopic radical thyroidectomy via air filled breast and chest approach

目的比较无充气腋窝入路腔镜甲状腺手术(TGET)与充气胸乳入路腔镜甲状腺手术(BAET)的临床治疗效果与安全性。方法选取2021年7月至2022年6月在赣州市人民医院甲状腺乳腺外科进行治疗的100例甲状腺癌患者作为研究对象,依据患者手术意愿分为TGET组与BAET组,每组各50例。比较两组患者的手术时间、术后引流情况、住院天数、术后并发症、术后颈部及胸部疼痛情况、术后美容效果。结果TGET组患者的术后引流量、术中总出血量均少于BAET组,差异有统计学意义(P<0.05);TGET组患者的创口感染、皮下积血、术后颈部异物感、术后积液发生率均低于BAET组,差异有统计学意义(P<0.05);TGET组患者术后3 d、术后1、3个月的疼痛评分低于BAET组,差异有统计学意义(P<0.05);两组患者的术后住院时间、手术时间、术后美容效果比较,差异无统计学意义(P>0.05)。结论TGET与BAET相比,在手术安全和术后颈部康复方面有明显优势。

Objective To compare the clinical efficacy and safety of transaxillay gasless endoscopic thyroidectomy(TGET)and endoscopic radical thyroidectomy via air filled breast and chest approach(BAET).Methods A total of 100 patients with thyroid cancer who were treated in People's Hospital of Ganzhou City from July 2021 to June 2022 were divided into two groups according to the patients'willingness to operate,with 50 patients in each group.The operation time,postoperative drainage,hospital stay,postoperative complications,postoperative neck and chest pain,and postoperative cosmetic effect of each patient in the TGET group and BAET group were compared.Results The postoperative drainage volume and total intraoperative blood loss indicators of patients in the TGET group were less than those in the BAET group,the differences were statistically significant(P<0.05);The Wound infection,subcutaneous hematocele,postoperative foreign body sensation in the neck,and postoperative fluid accumulation rate indicators of patients in the TGET group were lower than those in the BAET group,the differences were statistically significant(P<0.05);The pain score of TGET group was lower than that of BAET group at 3 days,1 month and 3 months after operation,the difference was statistically significant(P<0.05);There were no significant differences in the length of postoperative hospital stay,duration of surgery,or postoperative cosmetic outcome between the two groups(P>0.05).Conclusion TGET is superior to BAET in terms of surgical safety and postoperative cervical rehabilitation.