摘要
Abstract
Objective To compare the clinical efficacy of transareolar approach to papillary thyroid carcinoma(PTC)and lymph node dissection of low-collar approach in deep layer(VIB region)of the recurrent laryngeal nerve.Methods Clinical data of 68 PTC patients undergoing surgical treatment at the 901st Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from December 2021 to October 2023 were retrospectively analyzed.According to the surgical method,patients were divided into two groups:the transareolar group(n=34)and the low-collar incision approach group(n=34).The transareolar group underwent transareolar approach VIB lymph node dissection,and the low-collar incision group underwent low-collar incision VIB lymph node dissection.Perioperative indexes(intraoperative blood loss,operation time,postoperative drainage volume,hospital stay),postoperative complication rate,postoperative recurrence rate,stress response indexes(epinephrine E and norepinephrine NE),postoperative visual analogue score(VAS)and quality of Life(GQOLI-74)were compared.Results The transareolar group exhibited lower intraoperative blood loss and postoperative drainage volume,shorter hospital stay,higher aesthetic satisfaction of the surgical incision,and fewer complications compared to the low-collar incision group.The difference was statistically significant(P＜0.05).Conversely,the low-collar incision group demonstrated shorter operative time and lower recurrence rates.The difference was statistically significant(P＜0.05).Interaction effects between groups and time points were observed for E and NE levels(P＜0.05),with the transareolar group showing lower E and NE levels immediately and 2 hours postoperatively(P＜0.05).Postoperative VAS scores decreased progressively in both groups,but the transareolar group had lower scores at 1 day,3 days,and discharge(P＜0.05).At final follow-up,psychological and physical function scores on GQOLI-74 were higher in the transareolar group(P＜0.05),while social function and material status scores showed no significant intergroup differences(P＞0.05).Conclusions For PTC,the transareolar approach offers advantages in reduced bleeding,higher aesthetic satisfaction of the surgical incision,fewer complications and faster recovery,whereas the low-collar incision VIB lymph node dissection is associated with shorter operative time and lower recurrence rates.关键词
甲状腺乳头状癌/淋巴结清扫术/胸乳入路/低领式入路/喉返神经Key words
Papillary thyroid cancer/Lymph node dissection/Transareolar approach/Low collar approach/Recurrent laryngeal nerve
