经腋窝无充气入路与胸乳入路腔镜甲状腺手术的疗效对比

Comparison of the Efficacy of Endoscopic Thyroid Surgery through the Transaxil⁃lary Non-pneumatic Approach and the Thoracic and Breast Approach

目的针对甲状腺肿瘤患者的手术治疗作出探讨,分析经腋窝入路与经胸乳入路腔镜甲状腺切除术的效果。方法选取2022年7月—2023年6月普宁市人民医院收治的60例甲状腺肿瘤患者作为研究对象,根据不同手术入路方式随机分成两组进行手术治疗,其中30例采用经胸乳入路腔镜手术患者作为对照组,另外30例采用经腋窝入路无充气腔镜手术患者作为观察组,比较两组患者的手术相关指标、甲状腺功能、并发症情况及复发情况。结果观察组手术时间(56.88±13.59)min、术中出血量(13.97±8.51)mL、术后引流量(33.46±14.39)m L、术后住院时间(3.72±1.09)d,均优于对照组,差异有统计学意义(t=8.257、4.551、6.626、8.422,P<0.05);两组患者术后的甲状腺功能相比,差异无统计学意义(P>0.05)。结论经腋窝入路与经胸乳入路腔镜甲状腺切除术均为安全可行术式,但经腋窝入路无充气腔镜手术在手术时间、术中出血量、术后引流量、术后住院时间方面表现更为理想,有利于促进患者快速康复,缩短住院时间,值得在临床进一步推广。

Objective To discuss the surgical treatment of patients with thyroid tumors and analyze the effects of laparoscopic thyroidectomy through the axillary approach and the transthoracic approach.Methods 60 patients with thyroid tumor admitted to Puning People's Hospital from July 2022 to June 2023 were selected as the study objects and randomly divided into two groups for surgical treatment according to different surgical approaches.Among them,30 patients underwent transthoracic and breast approach endoscopic surgery as the control group,and the other 30 patients underwent transaxillary approach endoscopic surgery without air as the observation group.The surgical indicators,thyroid function,complications and recurrence were compared between the two groups.Results The operation time of the observation group was(56.88±13.59)min,the intraoperative blood loss was(13.97±8.51)mL,the postoperative drainage volume was(33.46±14.39)mL,and the postoperative hospitalization time was(3.72±1.09)d,which were all better than those of the control group,and the differences were statistically significant(t=8.257,4.551,6.626,8.422,P<0.05).There was no statistically significant difference in thyroid function between the two groups(P>0.05).Conclusion Both transaxillary and transthoracic approaches for laparoscopic thyroidectomy are safe and feasible.However,the performance of non-inflatable endoscopic surgery through the axillary approach is more ideal in terms of operation time,intraoperative blood loss,postoperative drainage volume,and postoperative hospitalization time.It is beneficial to promote rapid recovery of patients and shorten hospitalization time,and is worthy of further clinical promotion.