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经口内镜甲状腺切除术前庭入路与乳晕入路内镜甲状腺切除术治疗单侧甲状腺乳头状癌的回顾性研究。

Transoral Endoscopic Thyroidectomy Vestibular Approach Versus Endoscopic Thyroidectomy Via Areola Approach for Patients With Unilateral Papillary Thyroid Carcinoma: A Retrospective Study.

机构信息

Department of Thyroid Surgery, Hwa Mei Hospital.

Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences.

出版信息

Surg Laparosc Endosc Percutan Tech. 2021 Mar 17;31(5):550-553. doi: 10.1097/SLE.0000000000000932.

Abstract

BACKGROUND

Endoscopic thyroidectomy via areola approach (ETA) has been widely used in thyroidectomy for many years as it can effectively avoid a scar in the neck. Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is newly applied and has gained popularity quickly. This study is to compare the safety and effectiveness of TOETVA and ETA.

MATERIALS AND METHODS

A total of 95 patients who underwent TOETVA or ETA with unilateral papillary thyroid carcinoma were enrolled in this study from March 2019 to February 2020. The basic information (such as gender, age), intraoperative hemorrhage, postoperative drainage volume, hospital durations, intraoperative and postoperative complications, operative time, central lymph node dissection time, total number of central lymph nodes, and number of metastatic central lymph nodes were compared.

RESULTS

The operative time of the TOETVA group was significantly longer than the ETA group (148.11±19.78 vs. 135.90±12.77 min, P<0.05). However, the result was opposite when central lymph node dissection time was compared (10.31±2.93 vs. 12.48±3.55, P<0.05). TOETVA had an advantage on total number of central lymph nodes over ETA (7.82±3.35 vs. 5.26±2.45, P<0.05). No differences were found between the 2 groups on other data.

CONCLUSION

TOETVA and ETA have the similarity on surgical safety and effectiveness. TOETVA has its advantage on central lymph node dissection and might be a reasonable alternative for ETA and open surgery in the future.

摘要

背景

乳晕入路内镜甲状腺切除术(ETA)因其能有效避免颈部瘢痕,多年来已广泛应用于甲状腺切除术。经口内镜甲状腺切除术前庭入路(TOETVA)是新应用的方法,且迅速普及。本研究旨在比较 TOETVA 和 ETA 的安全性和有效性。

材料与方法

本研究纳入了 2019 年 3 月至 2020 年 2 月期间接受单侧甲状腺乳头状癌 TOETVA 或 ETA 的 95 例患者。比较了两组患者的基本信息(如性别、年龄)、术中出血量、术后引流量、住院时间、术中及术后并发症、手术时间、中央区淋巴结清扫时间、中央区淋巴结总数、中央区转移淋巴结数。

结果

TOETVA 组的手术时间明显长于 ETA 组(148.11±19.78 vs. 135.90±12.77 min,P<0.05)。然而,当比较中央区淋巴结清扫时间时,结果则相反(10.31±2.93 vs. 12.48±3.55,P<0.05)。TOETVA 在中央区淋巴结总数上优于 ETA(7.82±3.35 vs. 5.26±2.45,P<0.05)。两组在其他数据上无差异。

结论

TOETVA 和 ETA 在手术安全性和有效性上具有相似性。TOETVA 在中央区淋巴结清扫方面具有优势,可能是 ETA 和开放手术的合理替代方法。

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