小切口腔镜辅助下手术治疗分化型甲状腺癌

Minimal incisive surgery with endoscope-assistant for differentiated thyroid cancer

目的探讨将腔镜技术应用于分化型甲状腺癌的手术治疗的近期疗效及适应证。方法回顾性分析2009年9月至2011年5月上海交通大学医学院附属新华医院收治的26例分化型甲状腺癌病人资料,比较腔镜辅助下手术(研究组)和传统手术(对照组)在疗效、美容效果、合并症、手术时间、出血量等方面的差异。结果两组病人经5~20个月的随访均无复发和转移;在手术切除范围相同的情况下,手术时间差异无统计学院意义(P≥O.5);术中出血量术后引流量研究组少于对照组(P≤0.01),研究组多为第一次手术,对照组多为再次手术.两组之间在出血量和引流量方面没有可比性;美观度统微创组明显优于对照组(P≤0.01)。结论腔镜辅助下甲状腺癌联合根治手术是安全可行的,但要严格掌握适应证。

Object To explore the early therapeutic effect and indicition by surgery with endoscope technology for differentiated thyroid cancer.Methods To review 26 patients with differentiated thyroid carcinoma in therapeutic effect,cosmetic effect,complication,operative duration,blood loss between endoscopic surgery(research group) and traditional surgery(control group).The two groups were both undergone the totally thyroidectomy and neck dissection.Results All the patients in two groups are not recurrent and metastasis.There was no statistical difference in operative duration(P >0.05) with the same surgical resection range.The blood loss during operation and post-operative drainage in minimal incision group was less than control group(P <0.01) Most of minimal incision group underwent initial surgery,and the control group underwent second surgery.The two groups have no comparability in blood loss and post-operative drainage.So it is deemed no statistical difference and the cosmetic effect in minimal incision group was more satisfied than traditional group(P <0.01).Conclusion It's safe and feasible to do the totally thyroidectomy and neck dissection according to strict indication.