Ma T, Hao L, Shi P, Qiu M, Liang M, Sun Y F, Shi Y F
Department of Thyroid Surgery, the Affiliated Hospital of Jining Medical University, Jining 272000, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Aug 7;57(8):986-990. doi: 10.3760/cma.j.cn115330-20210901-00590.
To investigate the efficacy of transoral endoscopic thyroidectomy vestibular approach (TOETVA) assisted with submental mini-incision in early thyroid papillary carcinoma. A total of 63 patients with early papillary thyroid carcinoma (cT1N0M0) were included who underwent TOETVA from December 2019 to May 2021 in Department of Thyroid Surgery of the Affiliated Hospital of Jining Medical University. There were 4 males and 59 females, aged from 17 to 46 years old. Of those 36 patients received traditional TOETVA as control and 27 patients accepted modified TOETVA assisted with submental mini-incision. The clinical outcomes of patients in two groups were compared. Chi-square test and test were used in statistical analyses. Compared to control group, modified TOETVA group had the less mean operation time [(146.63±38.62) minutes . (167.78±36.71) minutes, =-2.21, =0.031], the shorter time required for returning to normal diet after operation [(2.11±0.89) days . (2.72±1.16) days, =-2.28, =0.026], and the lower probability of mandibular numbness (0 . 16.67%, χ=4.97, =0.026). There was no significant difference between two groups in intraoperative blood loss, postoperative drainage volume, number of central lymph nodes dissection, and postoperative complications such as gas embolism, postoperative bleeding, postoperative infection, skin burns, subcutaneous effusion and so on(all >0.05). After 6 months of operation, the thyroid ultrasound of the patients in two groups showed no recurrence, and the patients were satisfied with their surgical incision appearances. Both the modified and traditional TOETVA show similar efficacies for treatments of early thyroid papillary carcinoma, but the modified TOETVA can reduce the operation time and improve the quality of life.
探讨经口内镜甲状腺手术前庭入路(TOETVA)联合颏下小切口在早期甲状腺乳头状癌中的疗效。选取2019年12月至2021年5月在济宁医学院附属医院甲状腺外科接受TOETVA的63例早期甲状腺乳头状癌(cT1N0M0)患者。其中男性4例,女性59例,年龄17至46岁。36例患者接受传统TOETVA作为对照组,27例患者接受改良TOETVA联合颏下小切口。比较两组患者的临床结局。采用卡方检验和t检验进行统计分析。与对照组相比,改良TOETVA组平均手术时间更短[(146.63±38.62)分钟 对 (167.78±36.71)分钟,t=-2.21,P=0.031],术后恢复正常饮食所需时间更短[(2.11±0.89)天 对 (2.72±1.16)天,t=-2.28,P=0.026],下颌麻木概率更低(0对16.67%,χ²=4.97,P=0.026)。两组在术中出血量、术后引流量、中央淋巴结清扫数量以及气体栓塞、术后出血、术后感染、皮肤灼伤、皮下积液等术后并发症方面均无显著差异(均P>0.05)。术后6个月,两组患者甲状腺超声均未显示复发,且患者对手术切口外观满意。改良TOETVA和传统TOETVA在早期甲状腺乳头状癌治疗中疗效相似,但改良TOETVA可缩短手术时间并提高生活质量。