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传统开放甲状腺切除术与经腋下单切口机器人甲状腺切除术术后疼痛的比较:一项前瞻性研究。

A comparison of postoperative pain after conventional open thyroidectomy and transaxillary single-incision robotic thyroidectomy: a prospective study.

机构信息

Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

Ann Surg Oncol. 2013 Jul;20(7):2279-84. doi: 10.1245/s10434-012-2557-2. Epub 2013 Mar 26.

DOI:10.1245/s10434-012-2557-2
PMID:23529779
Abstract

BACKGROUND

The aim of this study was to compare conventional open thyroidectomy with robotic thyroidectomy in terms of postoperative pain.

METHODS

We compared the intensity of postoperative pain experienced by patients who received conventional open thyroidectomy (n = 45) versus those who underwent robotic thyroidectomy (n = 45). During surgery, we carefully controlled the anesthetic conditions. All the patients underwent a total thyroidectomy with ipsilateral central compartment node dissection. Postoperative pain in the 2 groups was compared using a visual analog scale and the amount of rescue analgesic at 30 min, 4 h, 1, 2, 3, and 10 days after surgery.

RESULTS

The postoperative pain at 30 min and 4 h after surgery were 3.0 ± 0.9 and 2.6 ± 0.9 (p = .066) and 4.9 ± 1.3 and 4.4 ± 1.3 (p = .055) in the conventional open group and the robotic group, respectively. The mean pain scores at 1, 2, 3, and 10 days after surgery were 3.8 ± 1.3 and 3.0 ± 1.3 (p = .001), 2.6 ± 1.2 and 2.0 ± 0.9 (p = .005), 1.7 ± 0.9 and 1.3 ± 0.6 (p = .034), and 0.9 ± 0.7 and 1.2 ± 1.1 (p = .093), respectively. No significant differences were observed between the 2 groups in terms of postoperative rescue analgesic use (1.1 ± 1.1 and 0.8 ± 0.9, p = .264).

CONCLUSIONS

Even though robotic thyroidectomy using the transaxillary technique requires a more extensive subcutaneous dissection than conventional open thyroidectomy, robotic thyroidectomy does not result in more postoperative pain or use of analgesic when compared with open thyroidectomy.

摘要

背景

本研究旨在比较传统开放甲状腺切除术与机器人甲状腺切除术在术后疼痛方面的差异。

方法

我们比较了接受传统开放甲状腺切除术(n = 45)和机器人甲状腺切除术(n = 45)患者的术后疼痛强度。手术过程中,我们仔细控制麻醉条件。所有患者均接受同侧中央区淋巴结清扫的全甲状腺切除术。通过视觉模拟评分和术后 30 分钟、4 小时、1 天、2 天、3 天和 10 天的止痛剂用量来比较两组的术后疼痛。

结果

术后 30 分钟和 4 小时时,传统开放组的疼痛评分为 3.0 ± 0.9 和 2.6 ± 0.9(p =.066),机器人组的疼痛评分为 4.9 ± 1.3 和 4.4 ± 1.3(p =.055)。术后 1、2、3 和 10 天时,平均疼痛评分分别为 3.8 ± 1.3 和 3.0 ± 1.3(p =.001)、2.6 ± 1.2 和 2.0 ± 0.9(p =.005)、1.7 ± 0.9 和 1.3 ± 0.6(p =.034)、0.9 ± 0.7 和 1.2 ± 1.1(p =.093)。两组患者术后止痛剂使用量无显著差异(1.1 ± 1.1 和 0.8 ± 0.9,p =.264)。

结论

尽管经腋窝入路的机器人甲状腺切除术比传统开放甲状腺切除术需要更广泛的皮下解剖,但与开放甲状腺切除术相比,机器人甲状腺切除术并不会导致更多的术后疼痛或需要使用更多的止痛剂。

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