不同手术方式治疗甲状腺癌的临床疗效分析

Three different surgical methods for thyroid cancer:a comparison of clinical effect

目的:探讨传统手术、腔镜经口腔前庭入路与经全乳晕入路手术治疗甲状腺癌的临床疗效。方法:回顾分析2018年4月至2021年5月收治的96例甲状腺乳头状癌患者的临床资料,按照手术方式分为传统组(n=48,颈部弧形切口)、前庭组(n=24,经口腔前庭入路)与全乳晕组(n=24,经全乳晕入路),均行单侧甲状腺切除+峡部切除+同侧中央组淋巴结清扫术,对比三组术中、术后情况。结果:3组手术时间差异有统计学意义(F=3.157,P<0.001);前庭组与全乳晕组的术后吞咽梗阻、总并发症发生率、美容满意度与传统组相比差异有统计学意义(P<0.05);3组在术中出血量、淋巴结清扫数量、术后12 h与24 h疼痛评分、引流量、术后住院时间及术后其他并发症方面差异无统计学意义(P>0.05)。结论:三种手术方式治疗甲状腺癌均是安全、有效的,应根据患者全身状况、肿瘤分期及患者意愿进行综合考虑,选择更合适的手术方式。

Objective:To explore the clinical efficacy of traditional operation,endoscopic surgery in oral vestibular approach and endoscopic surgery in total areola approach in the treatment of thyroid cancer.Methods:The clinical data of 96 patients with papillary thyroid cancer admitted from Apr.2018 to May 2021 were retrospectively analyzed.The patients were divided into the traditional group(n=48,neck curved incision),the vestibular group(n=24,oral vestibular approach)and the total areola group(n=24,total a reola approach)according to the surgical approach.All patients underwent unilateral thyroidectomy,isthmectomy and ipsilateral central group lymphadenectomy.Intraoperative and postoperative conditions of patients in the 3 groups were compared.Results:The difference in operative time among the 3 groups was statistically significant(F=3.157,P<0.001);the differences between the endoscopic group and the traditonal group in the postoperative swallowing obstruction,total complication rate and cosmetic satisfaction were statistically s ignificant(P<0.05).There were no significantly differences in blood loss,number of lymph node dissection,postoperative 12 h,24 h pain score,drainage v olume,postoperative hospital stay and other postoperative complications among the 3 groups(P>0.05).Conclusions:All the three surgical methods are safe and effective in the treatment of thyroid cancer.A comprehensive consideration should be made based on the patient's overall condition,tumor stage,and patient's willingness in order to choose the preferred surgical method.