无充气腋窝入路腔镜手术治疗甲状腺乳头状癌的临床效果

Effect of Endoscopic Thyroidectomy by a Gasless Unilateral Axillary Approach in the Treatment of Papillary Thyroid Carcinoma

目的比较无充气腋窝入路腔镜手术(GUA)与开放甲状腺手术(OT)治疗甲状腺乳头状癌的效果。方法回顾性分析2022年6—12月于郑州大学第一附属医院收治的接受甲状腺乳头状癌手术的患者。根据手术方式分为开放甲状腺手术组(OT组,82例)、无充气腋窝腔镜甲状腺手术组(GUA组,57例)。比较两组术中术后疗效指标、并发症等情况以及术后疼痛评分、美容满意度评分。结果所有患者均顺利完成手术。两组手术时间、术中出血量、阳性淋巴结数量、总淋巴结数量、术后引流量、拔管时间差异无统计学意义(P>0.05),而术后GUA组住院时间比OT组短(P<0.05)。两组并发症发生率差异无统计学意义(P>0.05)。GUA组较OT组疼痛评分低、美容满意度评分高、瘢痕自我关注度评分低(P<0.05)。结论GUA治疗甲状腺乳头状癌具有一定优势,能够在保证手术治疗效果的同时有效地缩短术后恢复时间,并满足患者对美容的需求,减轻术后疼痛程度,促进患者的快速康复。

Objective To compare the effect of endoscopic thyroidectomy by a gasless unilateral axillary approach(GUA)and open thyroidectomy(OT)in the treatment of papillary thyroid carcinoma.Methods A retrospective analysis was conducted on patients who underwent thyroid cancer surgery in the First Affiliated Hospital of Zhengzhou University from June to December 2022.They were divided into the traditional thyroid surgery group(OT group,82 cases)and the uninflated axillary lumpectomy thyroid surgery group(GUA group,57 cases)based on the surgical method.Curative effect and complications following surgery and postoperative pain score,beauty satisfaction score of two groups were compared.Results All patients successfully completed the operation.There was no statistical difference between the two groups in operation time,intraoperative blood loss,number of positive lymph nodes,total number of lymph nodes,postoperative drainage volume,and extubation time(P>0.05),and the postoperative hospital stay in the GUA group was shorter than that in the OT group(P<0.05).There was no statistical difference in the incidence of complications between the two groups(P>0.05).Compared with OT group,GUA group had lower pain score,higher aesthetic satisfaction score and lower scar self-concern score(P<0.05).Conclusion GUA has certain advantages in the treatment of papillary thyroid carcinoma,which can effectively shorten the postoperative recovery time while ensuring the surgical treatment effect,meet the needs of patients for beauty,reduce the degree of postoperative pain,and promote the rapid recovery of patients.