经腋窝腔镜下与传统甲状腺切除术治疗乳头状癌的疗效比较

Comparison of the efficacy of endoscopic thyroidectomy via axillary approach and conventional thyroidectomy in the treatment of papillary carcinoma

目的:探讨并比较经腋窝入路腔镜与传统甲状腺切除术治疗甲状腺乳头状癌的疗效。方法:回顾分析2022年9月至2023年10月收治的170例甲状腺手术患者的临床资料,其中90例经腋窝入路行腔镜甲状腺切除术(ETVA),80例行传统甲状腺切除术(CT)。比较ETVA组与CT组术中出血量、手术时间、术后引流量、术后住院时间、住院相关费用、术后疼痛评分及术后美容满意度。结果:ETVA组手术时间长于CT组[(136.21±33.86)min vs.(97.44±31.86)min,P<0.001],术中出血量[15(15, 20)mL vs. 15(15,15)mL,P=0.034]、术后引流量[145.50(111.50,176.25)mL vs. 52.00(34.00,68.00)mL,P<0.001]多于CT组,住院时间长于CT组[5(4,5)d vs. 4(4,5)d,P=0.001],住院期间的总费用高于CT组[25 952.22(24 902.50,26 968.14)元vs. 19 848.12(18 732.71,20 658.36)元,P<0.001],术后美容满意度高于CT组(96.67%vs. 78.75%,P<0.001)。结论:经腋窝入路腔镜甲状腺切除术与传统开放手术具有相近的手术疗效,但腔镜手术具有不可替代的美容效果,正逐渐成为有美容需求甲状腺疾病患者的选择。

Objective:This article aims to compare the efficacy of endoscopic thyroidectomy via axillary approach(ETVA)with conventional thyroidectomy(CT)in the treatment of papillary thyroid carcinoma.Methods:Clinical data of 170 patients who underwent thyroid surgery from Sep.2022 to Oct.2023 were retrospectively analyzed,including 90 patients undergoing ETVA,and 80 patients undergoing CT.The amount of intraoperative blood loss,operation time,postoperative drainage volume,postoperative hospitalization time,hospitalization costs,postoperative pain score and postoperative aesthetic satisfaction were compared between ETVA group and CT group.Results:The operation time of ETVA group was longer than that of CT group[(136.21±33.86)min vs.(97.44±31.86)min,P<0.001].Intraoperative blood loss[15(15,20)mL vs.15(15,15)mL,P=0.034]and postoperative drainage volume[145.50(111.50,176.25)mL vs.52.00(34.00,68.00)mL,P<0.001]in ETVA group were more than those in CT group.The time of postoperative hospitalization in ETVA group was longer than that in CT group[5(4,5)d vs.4(4,5)d,P=0.001].The total cost of hospitalization in ETVA group was more than that in CT group[25952.22(24902.50,26968.14)yuan vs.19848.12(18732.71,20658.36)yuan,P<0.001].Postoperative aesthetic satisfaction in ETVA group was higher than that in CT group(96.67%vs.78.75%,P<0.001).Conclusions:ETVA has similar surgical efficacy as conventional open thyroidectomy,and endoscopic thyroidectomy has irreplaceable cosmetic effects.Endoscopic thyroidectomy is becoming the surgical option for thyroid patients with cosmetic needs.