Yang Yu, Sun Donglin, Yang Junsheng, Chen Jing, Duan Yunfei
Department of General Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China.
J Laparoendosc Adv Surg Tech A. 2020 May;30(5):488-494. doi: 10.1089/lap.2019.0694. Epub 2020 Mar 17.
To compare the endoscopic thyroidectomy (ET) with the open thyroidectomy (OT) for patients with papillary thyroid carcinomas and share our experience of central lymph nodes dissection and recurrent laryngeal nerve exposure. From January 2015 to July 2017, 197 patients were enrolled in our hospital. Among them, 85 underwent ET and 112 underwent OT. The mean age of the patients was 38.15 ± 11.72 years in ET group and 47.79 ± 10.51 years in OT group. Unilateral thyroidectomy was performed in 47 patients of ET group and 63 patients of OT group. Bilateral thyroidectomy was performed in 38 patients of ET group and 49 patients of OT group. Intraoperative information, including operation time, hemorrhage, tumor size, capsular invasion, central LN metastasis, number of retrieved lymph nodes, hospital stay, cost, postoperative complication, and cosmetic satisfaction, was compared between the two groups. The operation time of ET group was significantly longer ( < .05). There were no significant differences between the two groups in postoperative complications ( > .05). The patients in ET group were more satisfied with the cosmetic effects ( < .05). ET was a safe and effective alternative operation method for selected patients with papillary thyroid carcinomas.
比较内镜甲状腺切除术（ET）与开放性甲状腺切除术（OT）治疗甲状腺乳头状癌患者的效果，并分享我们在中央淋巴结清扫和喉返神经显露方面的经验。2015年1月至2017年7月，我院共纳入197例患者。其中，85例行ET，112例行OT。ET组患者的平均年龄为38.15±11.72岁，OT组为47.79±10.51岁。ET组47例患者和OT组63例患者行单侧甲状腺切除术。ET组38例患者和OT组49例患者行双侧甲状腺切除术。比较两组患者的术中信息，包括手术时间、出血量、肿瘤大小、包膜侵犯、中央淋巴结转移、清扫淋巴结数量、住院时间、费用、术后并发症及美容满意度。ET组的手术时间明显更长（P<0.05）。两组术后并发症无显著差异（P>0.05）。ET组患者对美容效果更满意（P<0.05）。对于部分甲状腺乳头状癌患者，ET是一种安全有效的替代手术方法。
