乳晕入路腔镜甲状腺切除术与开放性甲状腺切除术治疗甲状腺癌患者的效果比较

Comparison of effects of endoscopic thyroidectomy via areola approach and open thyroidectomy in treatment of patients with thyroid microcarcinoma

目的:比较乳晕入路腔镜甲状腺切除术与开放性甲状腺切除术治疗甲状腺癌患者的效果。方法:选取2021年7月至2023年1月该院收治的82例甲状腺癌患者进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各41例。对照组行开放性甲状腺切除术治疗,观察组行经乳晕入路腔镜甲状腺切除术治疗。比较两组手术时间、术中出血量、住院时间、术后引流量,手术前后嗓音障碍指数(VHI)和吞咽障碍评分量表(SIS)评分,以及并发症发生率。结果:观察组手术时间、住院时间短于对照组,术中出血量、术后引流量少于对照组,差异均有统计学意义(P<0.05);术后3 d,两组VHI和SIS评分低于术前,且观察组低于对照组,差异均有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:乳晕入路腔镜甲状腺切除术治疗甲状腺癌患者可减少或降低术中出血量、术后引流量、SIS评分、VHI评分和并发症发生率,缩短手术时间和住院时间,效果优于开放性甲状腺切除术治疗。

Objective:To compare effects of endoscopic thyroidectomy via areola approach and open thyroidectomy in treatment of patients with thyroid microcarcinoma.Methods:A prospective study was conducted on 82 patients with thyroid microcarcinoma admitted to the hospital from July 2021 to January 2023.According to the random number table method,they were divided into observation group and control group,41 cases in each group.The control group was treated with open thyroidectomy,while the observation group was treated with endoscopic thyroidectomy via areola approach.The operation time,the intraoperative blood loss,the hospitalization time,the postoperative drainage volume,the voice handicap index(VHI) and the dysphagia score scale(SIS) score before and after surgery,and the incidence of complications were compared between the two groups.Results:The operation time and the hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss and the postoperative drainage volume were lower than those of the control group,and the differences were statistically significant(P<0.05).3 days after the surgery,the scores of VHI and SIS in the two groups were lower than those before the surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Endoscopic thyroidectomy via areola approach for the patients with thyroid microcarcinoma can reduce the intraoperative blood loss,the postoperative drainage,the SIS scores,the VHI scores,and the incidence of complications,and shorten the operation time and the hospitalization time.Moreover,it is superior to open thyroidectomy.