摘要
Abstract
Objective:To evaluate the clinical value of the surgical instrument string retractors in endoscopic thyroidectomy via the subclavian approach.Methods:The clinical data of 80 patients with papillary thyroid carcinoma who underwent endoscopic thyroid-ectomy via the subclavian approach between Feb.2024 and Dec.2024 were retrospectively analyzed.Patients were divided into a tradi-tional retractor group(control group,n=40)and an instrument string retractor group(study group,n=40).Standardized video analysis was employed to measure key surgical parameters,including the time required for thyroid upper pole dissection,the time for recurrent laryngeal nerve exposure,intraoperative blood loss volume,superior parathyroid gland exposure,external branch of superior laryngeal nerve identification,and instrument stability scores.Postoperative outcomes,including rates of recurrent laryngeal nerve injury and supe-rior laryngeal nerve injury,hypocalcemia,swallowing function scores at 1 week,and scar cosmesis assessment and rating scores at 3 months,were also compared.Results:All operations were completed successfully.The study group demonstrated significantly shorter time for thyroid upper pole dissection[(164.8±60.9)s vs.(291.8±99.6)s,P＜0.001],higher rates of the superior parathyroid gland exposure(70.0％vs.40.0％,P=0.007)and the external branch of the superior laryngeal nerve identification(67.5％vs.42.5％,P=0.025),along with higher instrument stability scores(P＜0.001).While the laryngeal nerve injury rate showed a decreasing trend(2.5％vs.12.5％,P=0.090),this difference lacked statistical significance.Swallowing function scores at 1 week postoperatively were significantly lower in the study group.No significant differences were found in scar scores or recurrent laryngeal nerve injury rates between the two groups.Conclusions:The surgical instrument string retractor offers distinct advantages in endoscopic thyroidectomy via the subclavian approach.Its core benefits include reducing the time for upper pole dissection,enhancing the exposure of nerve and para-thyroid glands,accelerating the recovery of postoperative swallowing function,and offering good cost-effectiveness.This technique pro-vides a feasible and practical option for implementing high-quality endoscopic thyroid surgery in primary hospitals.关键词
甲状腺切除术/内窥镜检查/锁骨下入路/手术拉钩Key words
Thyroidectomy/Endoscopy/Subclavian approach/Surgical retractor分类
医药卫生
