腹腔镜外科杂志2025，Vol.30Issue(8)：561-567,7.DOI:10.13499/j.cnki.fqjwkzz.2025.08.561
精细化被膜解剖技术在经锁骨下入路腔镜甲状腺癌手术中的临床疗效分析
Clinical efficacy analysis of meticulous capsular dissection in endoscopic thyroid cancer surgery via trans-subclavian approach
摘要
Abstract
Objective:To investigate the clinical efficacy of meticulous capsular dissection in endoscopic thyroid cancer surgery via trans-subclavian approach.Methods:A retrospective analysis was conducted on clinical data of 120 patients with unilateral thyroid cancer who underwent surgery from Jun.2023 to Dec.2024.The patients were divided into two groups based on the surgical approach:the endoscopy group(n=48)and the traditional group(n=72).The endoscopy group underwent endoscopic-assisted unilateral thyroid cancer surgery using meticulous capsular dissection technique via the subclavian approach,while the traditional group underwent unilat-eral thyroid cancer surgery via the traditional neck incision through the linea alba cervicalis.The following parameters were compared between the two groups:age,gender,BMI,tumor diameter,tumor location,number of positive central lymph nodes,operative time,inci-sion length,intraoperative blood loss,pain score at 24 hours postoperatively,postoperative drainage volume at 24 h,stress indicators be-fore and after surgery,postoperative voice status,neck traction sensation,and cosmetic satisfaction with the incision.Results:Patients in the endoscopy group were younger than those in the traditional group[(40.29±10.67)years vs.(51.28±13.82)years,P＜0.05].The operative time was longer in the endoscopy group[(86.31±25.77)min vs.(68.28±24.34)min,P＜0.05],but the incision length was shorter[(3.74±0.15)cm vs.(5.45±0.67)cm,P＜0.05].The endoscopy group had a lower incidence of neck traction sensation[(12(25％)vs.32(44.44％)],higher cosmetic satisfaction scores with the incision[3(2,3)points vs.2(1,3)points],lower 24-hour postoperative pain scores,and more 24-hour postoperative drainage volume(P＜0.05).There were no statistically signifi-cant differences between the two groups in terms of gender,BMI,tumor diameter,tumor location,number of positive central lymph nodes,intraoperative blood loss,stress indicators(interleukin-6,C-reactive protein)before and after surgery,or postoperative voice sta-tus(P＞0.05).Conclusions:Endoscopic thyroid cancer surgery via subclavian approach combined with meticulous capsular dissection technique is as safe and effective as traditional open thyroid surgery.Moreover,endoscopic thyroid surgery offers unique cosmetic effects and neck comfort,making it a viable option for thyroid cancer patients with aesthetic needs.关键词
甲状腺肿瘤/甲状腺切除术/内窥镜检查/经锁骨下入路/精细化被膜解剖Key words
Thyroid neoplasms/Thyroidectomy/Endoscopy/Trans-subclavian approach/Meticulous capsular dissection分类
医药卫生引用本文复制引用
邢家亮,孟佳佳,徐娜娜..精细化被膜解剖技术在经锁骨下入路腔镜甲状腺癌手术中的临床疗效分析[J].腹腔镜外科杂志,2025,30(8):561-567,7.基金项目
济南市卫生健康委员会科技计划项目(2023-2-87) （2023-2-87）
