免充气锁骨下入路腔镜甲状腺全切除术治疗甲状腺乳头状癌的单中心回顾性研究OACSTPCD
A single-centre retrospective study of gasless trans-subclavian endoscopic total thyroidectomy for papillary thyroid carcinoma
目的:探讨免充气锁骨下入路腔镜甲状腺全切除术治疗甲状腺乳头状癌的早期疗效.方法:回顾分析 2022 年12 月至2023 年12 月行免充气锁骨下入路腔镜甲状腺全切除术联合中央区淋巴结清扫术及传统开放入路甲状腺全切除术联合中央区淋巴结清扫术患者的临床资料.结果:共纳入 137 例,其中腔镜组 37 例,开放组 100 例.腔镜组年龄小于开放组[(44.24±8.44)岁vs.(49.08±10.82)岁],手术时间长于开放组[(106.89±21.90)min vs.(79.88±21.76)min],术后引流量多于开放组[(107.62±31.16)mL vs.(82.04±31.68)mL],术后美容满意度高于开放组[3(2,3)分vs.2(1,3)分],颈部不适感发生率低于开放组[7(18.9%)vs.43(43.0%)],差异均有统计学意义(P<0.05).两组患者性别、BMI、肿瘤直径、桥本甲状腺炎、T分期、术中出血量、中央区淋巴结清扫数量、中央区淋巴结阳性数量、术后引流管留置时间、术后甲状腺球蛋白水平差异无统计学意义(P>0.05);两组暂时性及永久性甲状旁腺功能减退、暂时性及永久性喉返神经损伤、血肿、发生率差异亦无统计学意义(P>0.05),两组均未发生淋巴漏、切口感染、气管损伤、食管损伤.结论:免充气锁骨下入路腔镜甲状腺全切除术联合中央区淋巴结清扫术治疗甲状腺乳头状癌安全、有效,美容效果及术后颈部舒适度优于传统开放甲状腺全切除术.
Objective:To investigate the short-term efficacy of gasless trans-subclavian endoscopic total thyroidectomy for papillary thyroid carcinoma.Methods:From Dec.2022 to Dec.2023,the clinical data of patients who underwent gasless trans-subclavian endoscopic total thyroidectomy combined with central lymph node dissection(endoscopic group)and patients who underwent conven-tional total thyroidectomy combined with central lymph node dissection(open group)in the same period were retrospectively analyzed.Results:A total of 137 patients were enrolled,including 37 cases in the endoscopic group and 100 cases in the open group.The average age of the endoscopic group was younger than that of the open group[(44.24±8.44)years vs.(49.08±10.82)years],and the opera-tion time was longer than that of the open group[(106.89±21.90)min vs.(79.88±21.76)min].The volume of postoperative drain-age in the endoscopic group were more than those in the open group[(107.62±31.16)mL vs.(82.04±31.68)mL].The cosmetic satisfaction in the endoscopic group was higher than that in the open group[3(2-3)vs.2(1-3)],and the incidence of neck discomfort in the endoscopic group was lower than that in the open group[7(18.9%)vs.43(43.0%)],with statistically significant differences(P<0.05).There were no significant differences between the two groups in gender,BMI,tumor diameter,Hashimoto's thyroiditis,T stage,intraoperative blood loss,the number of retrieved central lymph nodes,number of metastatic central lymph nodes,time of postope-rative drainage,and postoperative thyroglobulin level(P>0.05).In addition,there were no significant differences in incidence of tem-porary and permanent hypoparathyroidism,temporary and permanent recurrent laryngeal nerve injury,hematoma between the two groups(P>0.05).and no lymphatic leakage,incision infection,tracheal injury,and esophageal injury occurred Conclusions:Gasless trans-subclavian endoscopic total thyroidectomy combined with central lymph node dissection is a safe and effective surgical method for papil-lary thyroid carcinoma.Its cosmetic effect and postoperative neck comfort are better than those of traditional open thyroidectomy.
季笑语;邵毅;余恬湉;盛蕾;吕斌
山东大学齐鲁医院甲状腺外科,山东 济南,250012
临床医学
甲状腺肿瘤甲状腺切除术内窥镜检查锁骨下入路免充气
Thyroid neoplasmsThyroidectomyEndoscopyTrans-subclavian approachGasless
《腹腔镜外科杂志》 2024 (003)
167-173 / 7
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