经腋窝入路腔镜手术治疗单侧甲状腺乳头状癌的疗效分析

Analysis of Curative Effect of Endoscopic Surgery Through Axillary Approach in the Treatment of Unilateral Papillary Thyroid Carcinoma

目的分析经腋窝入路腔镜手术与传统开放式手术治疗单侧甲状腺乳头状癌的临床疗效。方法选取2020—2022年于内蒙古自治区人民医院甲状腺乳腺疝外科行手术治疗的108例单侧甲状腺癌患者为研究对象,其中42例行经腋窝入路腔镜甲状腺癌根治术,设为腔镜组;66例行传统开放式甲状腺癌根治术,设为开放组。比较两组患者一般资料、围手术期指标、术后总引流量、术后住院时间、术后颈部疼痛VAS评分以及术后并发症发生情况。结果两组患者一般资料差异无统计学意义(P>0.05);肿瘤直径、术中出血量、中央区淋巴结清扫数目、术后住院时间差异均无统计学意义(P>0.05);两组患者疼痛评分差异无统计学意义(P>0.05);腔镜组手术时间长于开放组,差异具有统计学意义(P<0.05);腔镜组术后引流量多于开放组,差异具有统计学意义(P<0.05);腔镜组术后吞咽障碍指数低于开放组,差异具有统计学意义(P<0.05);两组患者均未出现声音嘶哑、饮水呛咳、手足麻木等术后并发症。结论经腋窝入路腔镜甲状腺手术治疗单侧乳头状癌是安全有效的,值得临床推广应用。

Objective To analyse the clinical effect of axillary approach laparoscopic surgery and traditional open surgery for unilateral papillary thyroid carcinoma.Methods A total of 108 patients with thyroid cancer who underwent surgical treatment at the Inner Mongolia People’s Hospital thyroid and mammary hernia surgery from 2020 to 2022 were selected.Among them,42 patients underwent laparoscopic radical thyroid cancer resection axillary approach were selected as the endoscopic group.66 patients underwent traditional open radical resection of thyroid cancer were set as the open group.The general basic information,perioperative indicators,the total drainage,the postoperative hospital stay,the VAS score for postoperative neck pain and postoperative complications were compared between the two groups.Results There were on statistically significant differences between the two groups in general basic information,diameter of tumor,peroperative bleeding,central area dissection lymph node number,postoperative hospital stay and the VAS score for postoperative neck pain(P>0.05);Compared with open group,the operation time was significantly longer than the open group(P<0.05).The total drainage of the endoscopy group was more than the open group(P<0.05).But the DHI score of the endoscopy group was under than the open group(P<0.05).In addition,there were no postoperative complications in the two groups of patients.Conclusion Axillary approach laparoscopic surgery is feasible,safe,effective and commendable for unilateral papillary thyroid carcinoma.