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甲状腺癌微创甲状腺切除术的手术结果:与传统开放性甲状腺切除术的比较

Surgical outcomes of minimally invasive thyroidectomy in thyroid cancer: comparison with conventional open thyroidectomy.

作者信息

Kim Kwangsoon, Kang Sang-Wook, Kim Jin Kyong, Lee Cho Rok, Lee Jandee, Jeong Jong Ju, Nam Kee-Hyun, Chung Woong Youn

机构信息

Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

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

出版信息

Gland Surg. 2020 Oct;9(5):1172-1181. doi: 10.21037/gs-20-512.

Abstract

BACKGROUND

Minimally invasive thyroidectomy (MIT) is a safe method of performing thyroidectomy with notable benefits, such as improved cosmesis and reduced postoperative pain. The objective of this retrospective study was to report our experience with the technical feasibility of MIT, and compare its early surgical outcomes with those of conventional open thyroidectomy (COT) in patients with differentiated thyroid carcinoma (DTC).

METHODS

A total of 617 patients who underwent MIT and 2,674 patients who underwent COT were reviewed between March 2006 and November 2017 at Yonsei University (Seoul, Korea). The mean follow-up duration was 41.2±19.7 months.

RESULTS

The mean age of patients with DTC was 46.1±11.2 years. The mean operation time in the MIT group was significantly shorter than that of the COT group (63.5±26.2 85.3±36.8 minutes, P<0.001). The mean hospital stay was significantly shorter in the MIT group than it was in the COT group as well (2.7±0.6 3.1±0.8 days, P<0.001). There were significantly fewer painkillers used after surgery in the MIT group than in the COT group (1.2±0.5 2.7±1.6, P<0.001). The mean number of harvested LNs in the MIT group was significantly lower than that of the COT group (3.1±2.6 5.5±4.0, P<0.001).

CONCLUSIONS

This study demonstrated that MIT is technically feasible in patients with DTC. MIT is a valuable alternative operative technique to COT with good surgical outcomes and outstanding cosmetic results.

摘要

背景

微创甲状腺切除术(MIT)是一种安全的甲状腺切除方法,具有显著的益处,如改善美容效果和减轻术后疼痛。本回顾性研究的目的是报告我们在MIT技术可行性方面的经验,并比较其与传统开放性甲状腺切除术(COT)在分化型甲状腺癌(DTC)患者中的早期手术结果。

方法

2006年3月至2017年11月期间,对延世大学(韩国首尔)617例行MIT的患者和2674例行COT的患者进行了回顾性研究。平均随访时间为41.2±19.7个月。

结果

DTC患者的平均年龄为46.1±11.2岁。MIT组的平均手术时间显著短于COT组(63.5±26.2对85.3±36.8分钟,P<0.001)。MIT组的平均住院时间也显著短于COT组(2.7±0.6对3.1±0.8天,P<0.001)。MIT组术后使用的止痛药明显少于COT组(1.2±0.5对2.7±1.6,P<0.001)。MIT组切除的淋巴结平均数量显著低于COT组(3.1±2.6对5.5±4.0,P<0.001)。

结论

本研究表明,MIT在DTC患者中技术上是可行的。MIT是一种有价值的替代COT的手术技术,具有良好的手术效果和出色的美容效果。

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