中国耳鼻咽喉颅底外科杂志2026，Vol.32Issue(2)：87-90,4.DOI:10.11798/j.issn.1007-1520.202625259
改良无充气经锁骨下入路腔镜甲状腺手术的临床应用
Clinical application of modified gasless trans-subclavian approach endoscopic thyroidectomy
摘要
Abstract
Objective To evaluate the feasibility and safety of modified gasless endoscopic thyroidectomy via the subclavian approach for differentiated thyroid carcinoma.Methods A retrospective analysis was conducted on the clinical data of 53 patients with unilateral differentiated thyroid carcinoma(cTNM stage≤T1)who underwent surgery at the Department of Otorhinolaryngology Head and Neck Surgery of Xiangtan First People's Hospital from January 2023 to December 2023.All patients were divided into three groups:open thyroidectomy(open group,n=22),conventional subclavian endoscopic thyroidectomy approach(C-SETA group,n=18),and modified subclavian endoscopic thyroidectomy approach(M-SETA group,n=13).It was recorded and compared for the operation time,hospital stay,number of central lymph node dissections,postoperative complications and hospitalization costs of the three groups.The follow-up was conducted at the outpatient clinic from one month post-operation to January 2025.The quality of life was evaluated using the thyroid cancer-specific quality of life questionnaire.Results There were statistically significant differences in terms of operative time,length of hospital stay,number of central lymph node dissections,and quality of life scores among the three groups of patients(P<0.05).However,the hospitalization costs showed no statistically significant difference among the three groups of patients(P>0.05).The postoperative comparison showed that the operation time of both the laparoscopic groups was significantly longer than that of the open group(P<0.05),and there was no significant difference between the two endoscopic groups(P>0.05).The postoperative hospital stay of the endoscopic group was significantly shorter than that of the open group.The obtained number of lymph nodes was significantly higher in the endoscopic group than that in the open group.Furthermore,the scores of quality of life were significantly better in the endoscopic group than that in the open group(P<0.05).No postoperative complications(recurrent laryngeal nerve injury,superior laryngeal nerve injury,hypoparathyroidism,wound infection,hemorrhage)or tumor recurrence/metastasis occurred in any group during follow-up.Conclusions The modified gasless endoscopic thyroidectomy trans-subclavian approach(M-SETA)is a feasible and safe technique for treating differentiated thyroid carcinoma.The operation time is longer than that of open surgery,but it is comparable to the traditional axillary approach.M-SETA does not increase the risk of postoperative complications,achieves more lymph nodes thorough central compartment dissection(≥compared to the open group).This surgical procedure has a concealed incision,offering cosmetic advantages and shortening the hospital stay.M-SETA does not significantly increase costs compared to open surgery,which provides significantly better postoperative quality of life.关键词
甲状腺癌/腔镜手术/锁骨下入路/改良/生活质量Key words
Thyroid carcinoma/Endoscopic surgery/Subclavian approach/Modified/Quality of life分类
医药卫生引用本文复制引用
徐聪,黄程,沈文宇,张美兰,杨睿,唐庆利,阳外娇,廖建莹..改良无充气经锁骨下入路腔镜甲状腺手术的临床应用[J].中国耳鼻咽喉颅底外科杂志,2026,32(2):87-90,4.基金项目
湘潭市医学会一般项目(2024-xtyx-53). （2024-xtyx-53）
