中国现代手术学杂志2025，Vol.29Issue(6)：435-442,8.DOI:10.16260/j.cnki.1009-2188.2025.06.001
经口腔前庭入路与开放甲状腺全切联合中央区淋巴结清扫的疗效比较
Comparative efficacy of transoral vestibular approach versus open surgery for total thyroidectomy with central neck lymph node dissection
摘要
Abstract
Objective To compare the clinical outcomes of transoral endoscopic thyroidectomy vestibular approach(TOETVA)and conventional open thyroidectomy(COT)for papillary thyroid carcinoma(PTC)in total thyroidectomy with central neck lymph node dissection.Methods A retrospective analysis was performed on PTC patients who underwent total thyroidectomy with central neck lymph node dissection at our hospital between January 2018 and June 2024.Propensity score matching(PSM)was used to divide the patients into the TOETVA group(n=30)and the COT group(n=62).The following parameters were compared between the two groups:baseline characteristics;surgical indicators,including intraoperative blood loss,number of central lymph nodes dissected,operation time,postoperative drainage volume,and postoperative hospital stay;serological markers,including thyroglobulin(Tg),thyroglobulin antibody(TgAb),C-reactive protein(CRP),and white blood cell count(WBC);and the incidence of postoperative complications,such as recurrent laryngeal nerve palsy,hypo-parathyroidism,infection,chyle leakage,and hematoma.Postoperative pain visual analog scale(VAS)scores,surgical satisfaction,and recovery status were evaluated.Results No significant differences were observed between the two groups in intraoperative blood loss,number of lymph nodes dissected,or postoperative hospital stay(all P>0.05).However,the TOETVA group had a longer operation time and a higher postoperative drainage volume compared to the COT group(P<0.001).There were no statistically significant differences between the two groups in serum Tg levels,TgAb positivity rates,CRP,WBC,or complication rates(all P>0.05).The TOETVA group showed significantly lower VAS scores on postoperative days 1,2,and 3(all P<0.001),and higher satisfaction scores at 1,3,and 6 months postoperatively(all P<0.05).Conclusion TOETVAdemonstrates comparable surgical safety and clinical efficacy to COT in total thyroidectomy with central neck lymph node dissection for PTC,while offering the advantages of reduced postoperative pain,superior cosmetic results,and higher patient satisfaction.关键词
甲状腺乳头状癌/经口腔前庭入路腔镜甲状腺切除术/甲状腺全切术/中央区淋巴结清扫Key words
papillary thyroid carcinoma/transoral endoscopic thyroidectomy vestibular approach/total thyroidectomy/central neck lymph node dissection引用本文复制引用
陈皆超,赵怡,徐艳波,杨坤,盛宇伟..经口腔前庭入路与开放甲状腺全切联合中央区淋巴结清扫的疗效比较[J].中国现代手术学杂志,2025,29(6):435-442,8.基金项目
2023～2025年度宝山区卫生健康委员会科研课题[BSZK-2023-BZ02(02)] （02）
