Wang Mingliang, Zhang Tao, Mao Zhihai, Dong Feng, Li Jianwen, Lu Aiguo, Hu Weiguo, Zang Lu, Jiang Yu, Zheng Minhua
Shanghai Minimally Invasive Surgery Center, Surgery Department, Shanghai Ruijin Hospital affiliated with Shanghai JiaoTong University Medical School, Shanghai, China.
J Laparoendosc Adv Surg Tech A. 2009 Apr;19(2):149-52. doi: 10.1089/lap.2008.0296.
The aim of this study was to evaluate the inflammatory response and acid-base equilibrium index, as well as other clinical facts of the endoscopic thyroidectomy via the anterior chest wall approach.
Thirty-nine patients who received thyroidectomy in our surgical center during September 2007 and January 2008 were included in this study. Twenty of the patients underwent an endoscopic surgery, and the remaining 19 received conventional surgery. These patients' data were compared within and between treatment groups with respect to clinical facts and inflammatory evaluations. Arterial blood gas data and electrolyte data were analyzed within the endoscopic group.
Endoscopic thyroidectomy group showed shorter operative time, compared to that of the conventional thyroidectomy group, although the difference didn't reach statistical significance. No significant difference regarding postoperative hospital stay was observed between two groups. Postoperative day 1 shows much higher values of interleukin-6 and tumor necrosis factor than that measured preoperative or postoperative day 3 in both groups. C-reactive protein appeared to be significantly increased postoperatively in both groups, although no difference between the two groups was found. Although blood cortisol significantly increased in both groups postoperatively, the data of endoscopic group postoperative day 1 was lower than the same day of the conventional group. Arterial blood gas analysis showed that both PCO2 and TCO2 were statistically different between preoperation and 30 minutes after insufflation. No insufflation complication was observed.
Compared with conventional thyroid surgery, endoscopic thyroidectomy via the anterior chest wall approach presented with no significant difference in respect of both clinical facts and laboratory outcomes.
本研究旨在评估经胸前壁入路内镜甲状腺切除术的炎症反应、酸碱平衡指标以及其他临床情况。
本研究纳入了2007年9月至2008年1月在我院手术中心接受甲状腺切除术的39例患者。其中20例行内镜手术,其余19例行传统手术。对这些患者的临床情况和炎症评估数据在治疗组内及组间进行比较。对内镜组患者的动脉血气数据和电解质数据进行分析。
与传统甲状腺切除术组相比,内镜甲状腺切除术组的手术时间较短,尽管差异未达到统计学意义。两组术后住院时间无显著差异。两组术后第1天的白细胞介素-6和肿瘤坏死因子值均高于术前或术后第3天所测值。两组术后C反应蛋白均明显升高,尽管两组间无差异。虽然两组术后血皮质醇均显著升高,但内镜组术后第1天的数据低于传统组同一天的数据。动脉血气分析显示,术前与气腹30分钟后PCO2和TCO2均有统计学差异。未观察到气腹并发症。
与传统甲状腺手术相比,经胸前壁入路内镜甲状腺切除术在临床情况和实验室结果方面均无显著差异。