男性甲状腺肿瘤患者行颏下联合经口腔前庭入路腔镜甲状腺手术的安全性和美容效果分析

Hybrid-transoral endoscopic thyroidectomy submental access for male thyroid tumors:Preliminary clinical study on safety and cosmetic effects

目的分析男性患者选择颏下联合经口腔前庭入路腔镜甲状腺手术(H-TOETSA)治疗甲状腺肿瘤的安全性和美容效果。方法收集2021年9月—2022年4月诊治的55例男性甲状腺肿瘤手术患者的临床资料,其中30例选择了H-TOETSA手术方式,同期25例患者选择传统的“衣领式”颈部皮肤切开甲状腺手术。比较H-TOETSA术式和传统的“衣领式”颈部皮肤切开术式组的一般资料、临床指标(手术时间、术后引流量、术后住院天数)和并发症(喉返神经损伤、永久性甲状旁腺功能低下、手术部位感染以及颏部麻木感)的发生情况。术后1个月门诊复查时评估患者美容效果的满意度。结果选用H-TOETSA术式组的患者与传统的“衣领式”颈部皮肤切开术式组比较,手术用时较长(153.233±40.826 vs 122.960±37.821),术后住院天数较短(2.733±0.907 vs 3.480±1.005),差异均具有统计学意义(P<0.05)。术后颏部麻木感未明显增加、引流量及手术并发症的发生几率差异均无统计学意义(P>0.05)。术后随访1个月,选用H-TOETSA术式组患者的主观美容满意度显著高于传统的“衣领式”颈部皮肤切开术式组(8.733±0.450 vs 7.680±0.476,P=0.000)。结论合适的男性甲状腺肿瘤患者选择H-TOETSA手术的安全性不劣于传统开放手术,适用于有美容需求的患者。

Objective To preliminarily analyze the safety and cosmetic effects of Hybrid-transoral endoscopic thyroidectomy submental access(H-TOETSA)for male patients with thyroid tumors.Methods Clinical data of 55 male patients,undergoing thyroid tumor surgery from September 2021 to April 2022 were collected.Among them,30 patients underwent H-TOETSA(experimental group),while 25 patients underwent thyroid surgery via traditional“collar style”neck skin incision(control group)during the same period.The general information,clinical parameters(surgical time,postoperative drainage volume,postoperative hospital stay),and complications(recurrent laryngeal nerve injury,permanent hypothyroidism,infection,and chin numbness)between the two groups were compared.The patient satisfaction with cosmetic outcomes was assessed one month after surgery.Results Compared with the control group,the experimental group had longer surgical time(153.233±40.826 vs 122.960±37.821)and shorter postoperative hospitalization days(2.733±0.907 vs 3.480±1.005),and the differences were statistically significant(P<0.05).There were no statistically significant differences in postoperative mental numbness,postoperative drainage volume and complications between the two groups(P>0.05).The subjective cosmetic satisfaction of the experimental group was significantly higher than that of the control group(8.733±0.450 vs 7.680±0.476,P=0.000).Conclusion Without safety disadvantages,the H-TOETSA is suitable for male thyroid tumor patients with cosmetic needs.