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基于 356 例回顾性研究的 PTC 患者全内镜甲状腺切除术的简单辅助方法标准化。

Standardization of simple auxiliary method beneficial to total endoscopic thyroidectomy on patients with PTC, based on retrospective study of 356 cases.

机构信息

Department of Thyroid and Vascular Surgery, Fujian Medical University Union Hospital, 350000, Fuzhou, Fujian, China.

Department of General Surgery, Fujian Medical University Union Hospital, 350000, Fuzhou, Fujian, China.

出版信息

Endocrine. 2018 Jul;61(1):51-57. doi: 10.1007/s12020-018-1600-x. Epub 2018 Apr 24.

Abstract

OBJECTIVE

Total endoscopic thyroidectomy (TET) is paid increasing attention to by patients, especially those with thyroid carcinoma. The aim of this study is to evaluate the clinic feasibility of standardization of simple auxiliary method (SOSAM) involved in operating bed adjustment, location of skin traction points and thyroid retractor points for the TET via bilateral breast approach.

METHODS

A retrospective study was performed on 356 patients with thyroid carcinoma, who had undergone the TET. Patients were divided into Group A (with the SOSAM) and Group B (without the SOSAM). This study compares the surgical outcome parameters between the two groups, including the total operative time, hemorrhage volume during operation, postoperative hospitalization days, numbers of dissecting and metastatic lymph nodes, and postoperative complication.

RESULT

The total operative time, hemorrhage volume and postoperative hospitalization days in Group A were significantly lower than those in Group B (P < 0.05). Nevertheless no statistically significant differences were found in both groups in terms of other observation indexes (P > 0.05), including numbers of dissecting and metastatic lymph nodes, and postoperative complication. Meanwhile, there were no patients with incision and surgical site infection, air embolism, and flap injury occurred in both groups.

CONCLUSION

The clinical application of the SOSAM can effectively decrease the total operative time and hemorrhage during operation. Moreover, it can be used in a wider range of popularization to improve the operative effect for total endoscopic thyroidectomy.

摘要

目的

全内镜甲状腺切除术(TET)越来越受到患者的关注,尤其是甲状腺癌患者。本研究旨在评估通过双侧乳晕入路的标准化简单辅助方法(SOSAM)在手术床调整、皮肤牵引点和甲状腺牵开器点定位方面对 TET 的临床可行性。

方法

回顾性分析了 356 例甲状腺癌患者的 TET 手术资料,患者分为 A 组(采用 SOSAM)和 B 组(未采用 SOSAM)。比较两组的手术结果参数,包括总手术时间、术中出血量、术后住院天数、解剖和转移淋巴结数量以及术后并发症。

结果

A 组的总手术时间、术中出血量和术后住院天数明显低于 B 组(P<0.05)。然而,两组在其他观察指标(包括解剖和转移淋巴结数量以及术后并发症)方面均无统计学差异(P>0.05)。同时,两组均无切口和手术部位感染、空气栓塞和皮瓣损伤发生。

结论

SOSAM 的临床应用可有效缩短总手术时间和术中出血量。此外,它可以更广泛地推广应用,以提高全内镜甲状腺切除术的手术效果。

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