[1]龚文杰,李德昭,江　涛,等.免充气腔镜下经腋窝入路与传统颈前入路单侧甲状腺全切术治疗单侧甲状腺良性肿瘤临床疗效比较[J].新乡医学院学报,2022,39(7):622-625.[doi:10.7683/xxyxyxb.2022.07.005]
　GONG Wenjie,LI Dezhao,JIANG Tao,et al.Comparison of clinical effect of unilateral total thyroidectomy via axillary approach under non-inflatable endoscope and traditional anterior cervical approach in treatment of unilateral benign thyroid tumors[J].Journal of Xinxiang Medical University,2022,39(7):622-625.[doi:10.7683/xxyxyxb.2022.07.005]
点击复制

免充气腔镜下经腋窝入路与传统颈前入路单侧甲状腺全切术治疗单侧甲状腺良性肿瘤临床疗效比较
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年7
页码:
622-625
栏目:
临床研究
出版日期:
2022-07-05

文章信息/Info

Title:
Comparison of clinical effect of unilateral total thyroidectomy via axillary approach under non-inflatable endoscope and traditional anterior cervical approach in treatment of unilateral benign thyroid tumors
作者:
龚文杰; 李德昭; 江　涛; 李海峰; 王荣寅
（蚌埠医学院附属蚌埠市第三人民医院微创外科，安徽　蚌埠　233000）
Author(s):
GONG Wenjie; LI Dezhao; JIANG Tao; LI Haifeng; WANG Rongyin
（Minimally Invasive Surgery,the Third People′s Hospital of Bengbu City Affiliated to Bengbu Medical College,Bengbu 233000，Anhui Province，China）
关键词:
甲状腺良性肿瘤; 甲状腺切除术; 免充气腋窝入路; 颈前入路; 美容满意度
Keywords:
benign thyroid tumor; thyroidectomy; non-inflatable endoscopic transaxillary approach; anterior cervical approach; cosmetic satisfaction
分类号:
R653
DOI:
10.7683/xxyxyxb.2022.07.005
文献标志码:
A
摘要:
目的　比较免充气腔镜下经腋窝入路与传统颈前入路单侧甲状腺全切术治疗单侧甲状腺良性肿瘤的临床效果。方法　选择2020年1月至2021年1月于蚌埠医学院附属蚌埠市第三人民医院行手术治疗的单侧甲状腺良性肿瘤患者62例为研究对象，根据手术方式将患者分为观察组（n=30）和对照组（n=32）。观察组患者采用免充气腔镜下经腋窝入路单侧甲状腺全切术，对照组患者采用传统颈前入路单侧甲状腺全切术。比较2组患者的手术时间、术中出血量、术后引流量、住院时间、术后并发症及总体满意度。结果　观察组患者手术时间、住院时间显著长于对照组，术后引流量显著多于对照组，术中出血量显著少于对照组，术后3个月满意度评分显著高于对照组（P<0.05）。对照组患者术后发生饮水呛咳1例（3.13%），声音嘶哑2例（6.25%），低钙血症1例（3.13%），术后并发症发生率为12.51%（4/32）；观察组患者术后发生饮水呛咳1例（3.33%），声音嘶哑1例（3.33%），术后6 h切口渗血1例（3.33%），术后并发症发生率为10.0%（3/30）；2组患者的术后并发症发生率比较差异无统计学意义( χ2=0.000，P>0.05)。结论　与颈前入路单侧甲状腺全切术相比，免充气腔镜下经腋窝入路单侧甲状腺全切术治疗单侧甲状腺良性肿瘤安全有效，可行性强，美容性好，患者满意度高。
Abstract:
Objective　To compare the clinical effect of unilateral total thyroidectomy via axillary approach under non-inflatable endoscope and traditional anterior cervical approach in the treatment of unilateral benign thyroid tumors.Methods　A total of 62 patients with unilateral benign thyroid tumors who underwent operation in the Third People′s Hospital of Bengbu City Affiliated to Bengbu Medical College from January 2020 to January 2021 were selected as research objects,and the patients were divided into the observation group (n=30) and the control group (n=32) according to the mode of operation.The patients in the observation group underwent unilateral total thyroidectomy via axillary approach under non-inflatable endoscope,the patients in the control group underwent unilateral total thyroidectomy via anterior cervical approach.The operation time,intraoperative blood loss,postoperative drainage,hospitalization time,postoperative complications and overall satisfaction were compared between the two groups.Results　The operation time and hospitalization time of patients in the observation group were significantly longer than those in the control group,the postoperative drainage of patients in the observation group was significantly higher than that in the control group,the intraoperative blood loss of patients in the observation group were significantly lower than that in the control group,the satisfaction score of patients in the observation group was significantly higher than that in the control group at three months after operation (P<0.05).In the control group,there were 1 case(3.13%) of drinking water cough,2 cases(6.25%) of hoarseness and 1 case(3.13%) of hypocalcemia;the incidence of postoperative complications was 12.51% (4/32).In the observation group,there were 1 case(3.33%) of drinking water cough,1 case(3.33%) of hoarseness,1 case(3.33%)of incision bleeding at six hours after operation;the incidence of postoperative complications was 10.0%(3/30).There was no significant difference in the incidence of postoperative complications of patients between the two groups(χ2=0.000,P>0.05).Conclusion　Compared with unilateral total thyroidectomy via anterior cervical approach,unilateral total thyroidectomy via axillary approach under non-inflatable endoscope in the treatment of unilateral benign thyroid tumors is safe,effective and feasible;its cosmetic is good,and patient′s satisfaction is higher.

参考文献/References:

［1］　赵北永，宋晓丹，关华鹤.两种腹腔镜手术方案治疗甲状腺良性肿瘤的对比分析［J］.腹腔镜外科杂志，2020，25（2）：90-93.
ZHAO B Y，SONG X D，GUAN H H.Clinical comparison of two kinds of laparoscopic surgical procedures in the treatment of benign thyroid tumors［J］.J Laparosc Surg，2020，25（2）：90-93.
［2］　MCCLEAN S，OMAKOBIA E，ENGLAND R J A.Comparing ultrasound assessment of thyroid nodules using BTA U classification and ACR TIRADS measured against histopathological diagnosis［J］.Clin Otolaryngol，2021，46（6）：1286-1289.
［3］　KIHARA M，MIYAUCHI A，HIROKAWA M，et al.Long-term outcomes of cytologically benign thyroid tumors:a retrospective analysis of 3,102 patients at a single institution［J］.Endocr J，2021，68（12）：1373-1381.
［4］　YULIAN E D，KURNIA A，KARTINI D,et al.Endoscopic thyroide-ctomy via axillary-breast-shoulder approach：early experience of 42 cases［J］.Surg Oncol，2020，34：318-323.
［5］　SHEN S，HU X C，QU R，et al.Comparing quality of life between patients undergoing trans-areola endoscopic thyroid surgery and trans-oral endoscopic thyroid surgery［J］.BMC Surg，2021，21（1）：277.
［6］　CHANG Y W，LEE H Y，JI W B，et al.Detailed comparison of robotic and endoscopic transaxillary thyroidectomy［J］.Asian J Surg，2020，43（1）：234-239.
［7］　YU W B，LI F，WANG Z，et al.Effects of CO2 insufflation on cerebrum during endoscopic thyroidectomy in a porcine model［J］.Surg Endosc,2011,25（5）：1495-1504.
［8］　邬一军,朱峰,沈亦斌,等.颈侧方切口甲状腺手术的步骤及要点［J］.浙江大学学报(医学版)，2021，50（6）：701-706.
WU Y J，ZHU F，SHEN Y B，et al.The steps and key points of thyroid surgery with lateral cervical incision［J］.J Zhejiang Univ Med Sci，2021，50（6）：701-706.
［9］　HSCHER C S，CHIODINI S，NAPOLITANO C，et al．Endoscopic right thyroid lobectomy［J］.Surg Endosc，1997，11（8）：877．
［10］　徐加杰，张李卓，张启弘，等.无充气经腋窝腔镜甲状腺手术的临床应用［J］.中华耳鼻咽喉头颈外科杂志，2020，55（10）：913-920．
XU J J，ZHANG L Z，ZHANG Q H，et al.Clinical application of the gasless unilateral axillary approach in endoscopic thyroid surgery［J］.Chin J Otorhinolaryngol Head Neck Surg，2020，55（10）：913-920．
［11］　CHUNG Y S，CHOE J H，KANG K H，et al.Endoscopic thyroide-ctomy for thyroid malignancies:comparison with conventional open thyroidectomy［J］.World J Surg，2007，31（12）：2302-2306.
［12］　王佳峰，徐加杰，蒋烈浩，等.无充气腋窝入路完全腔镜下甲状腺癌根治术对术后颈部功能影响的初步研究［J］.中华内分泌外科杂志，2021，5（1）：10-14．
WANG J F，XU J J，JIANG L H，et al.Preliminary evaluation of neck function in patients with papillary thyroid carcinoma after endoscopic thyroidectomy using the gasless axillary approach［J］.Chin J Endocr Surg，2021，5（1）：10-14．
［13］　ZHENG G B，XU J J，WU G C，et al.Transoral versus gasless transaxillary endoscopic thyroidectomy：a comparative study［J］.Updates surg，2021，74（1）：295-302.
［14］　PICCOLI M，MULLINERIS B，GOZZO D，et al.Evolution strategies in transaxillary robotic thyroidectomy:considerations on the first 449 cases perform［J］.J Laparoendosc Adv Surg Tech A，2019，29（4）：433-440.
［15］　NAYAK S P，SADHOO A，GANGADHARA B，et al.Robotic-assisted breast-axillo insufflation thyroidectomy (RABIT):a retrospective case series of thyroid carcinoma［J］.Int J Clin Oncol，2020，25（3）：439-445.
［16］　KIM E Y，LEE K H，PARK Y L，et al.Single-incision，gasless，endoscopic transaxillary total thyroidectomy:a feasible and oncologic safe surgery in patients with papillary thyroid carcinoma［J］.J Laparoendosc Adv Surg Tech A，2017，27（11）：1158-1164．
［17］　李秀萍，俞红梅，徐志伟，等.改良无充气经腋窝腔镜甲状腺手术治疗甲状腺微小乳头状癌的疗效分析［J］.中华内分泌外科杂志，2021，15（3）：273-277.
LI X P，YU H M，XU Z W，et al.Efficacy of the modified gasless unilateral axillary approach endoscpic thyroid surgery in the treatment of papillary thyroid micropapillary［J］.Chin J Endocr Surg，2021，15（3）：273-277.

相似文献/References:

[1]李　鹏,罗瑞华,郭兰伟,等.开放性甲状腺癌手术患者术后出血相关危险因素分析[J].新乡医学院学报,2020,37(3):274.[doi:10.7683/xxyxyxb.2020.03.018]
　LI Peng,LUO Ruihua,GUO Lanwei,et al.Analysis of related risk factors of postoperative hemorrhage in patients undergoing open thyroid cancer operation[J].Journal of Xinxiang Medical University,2020,37(7):274.[doi:10.7683/xxyxyxb.2020.03.018]

更新日期/Last Update: 2022-07-05