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传统开放性甲状腺切除术与单切口、免气、内镜经腋窝甲状腺切除术术后疼痛的比较:单机构前瞻性研究

A comparison of postoperative pain after conventional open thyroidectomy and single-incision, gasless, endoscopic transaxillary thyroidectomy: a single institute prospective study.

作者信息

Kang Jung Bong, Kim Eun Young, Park Yong Lai, Park Chan Heun, Yun Ji-Sup

机构信息

Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Ann Surg Treat Res. 2017 Jan;92(1):9-14. doi: 10.4174/astr.2017.92.1.9. Epub 2016 Dec 30.

Abstract

PURPOSE

The aim of this study was to compare postoperative pain between single-incision, gasless, endoscopic transaxillary thyroidectomy (SET), and conventional open thyroidectomy.

METHODS

From March to December 2015, patients with thyroid disease underwent total thyroidectomy or lobectomy. Patient's clinical and pathological characteristics, postoperative pain score using visual analog scale (VAS) were compared between the 2 groups. The primary endpoint was postoperative pain evaluated by VAS score and postoperative analgesic use. Operation time and length of postoperative hospital stay were secondary outcome measures.

RESULTS

Conventional, open cervical surgery was performed on 30 patients (group O) and SET was performed on 27 patients (group E). Pain scores in shoulder area, which is the ipsilateral side of the tumor location at 1 hour and 24 hours after surgery, were higher in group E patients (P < 0.05). Pain scores 7 days after surgery did not differ between the 2 groups according to the locations (P < 0.05).

CONCLUSION

In conclusion, endocrine surgeons should be concerned about immediate higher postoperative pain scores in patients who undergo SET.

摘要

目的

本研究旨在比较单切口、无气、内镜经腋窝甲状腺切除术(SET)与传统开放性甲状腺切除术的术后疼痛情况。

方法

2015年3月至12月,甲状腺疾病患者接受了全甲状腺切除术或甲状腺叶切除术。比较两组患者的临床和病理特征,以及使用视觉模拟量表(VAS)评估的术后疼痛评分。主要终点是通过VAS评分评估的术后疼痛及术后镇痛药物的使用情况。手术时间和术后住院时间为次要观察指标。

结果

30例患者接受了传统开放性颈部手术(O组),27例患者接受了SET手术(E组)。术后1小时和24小时,E组患者肿瘤同侧肩部区域的疼痛评分较高(P<0.05)。术后7天,两组在各部位的疼痛评分无差异(P<0.05)。

结论

总之,内分泌外科医生应关注接受SET手术患者术后早期较高的疼痛评分。

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