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双侧腋窝-乳房入路机器人辅助手术在肥胖甲状腺癌女性患者中的临床研究

[Clinical study of bilateral axillo-breast approach robot in obese women with thyroid cancer].

作者信息

Ding Yuqiang, Wang Meng, Li Yanchen, Zhou Peng, Zhu Jian, Wang Gang, Wang Dan, Zheng Luming, He Qingqing

机构信息

Graduate Training Base of PLA 960th Hospital of Jinzhou Medical University,Jinan,250031,China.

Department of Thyroid and Breast Surgery,PLA 960 Hospital.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Apr;37(4):288-292. doi: 10.13201/j.issn.2096-7993.2023.04.010.

Abstract

To explore the safety and feasibility of bilateral axillo-breast approach (BABA) robot in the operation of thyroid cancer in obese women. The clinical data of 81 obese female patients who underwent da Vinci robotic thyroid cancer surgery(robotic group) at the Department of Thyroid and Breast Surgery, PLA 960 Hospital from May 2018 to December 2021 were retrospectively analyzed and compared with the clinical data of 106 obese female thyroid cancer patients who underwent open surgery(open group) during the same period. The age, body mass index(BMI), mean time of surgery, mean postoperative drainage, tumor diameter, postoperative tumor stage, number of lymph node dissection in the central and lateral cervical regions, number of positive lymph nodes in the central and lateral cervical regions, postoperative cosmetic outcome satisfaction score, mean postoperative hospital stay and postoperative complications of all patients were counted. The results were analyzed using SPSS 26.0 statistical software, and the count data were compared using the ² test, and the measurement data were compared using the test. All patients completed the operation successfully, and there was no conversion in the robot group, postoperative pathological results were all composed of papillary thyroid carcinoma. The operation time in the robot group was(144.62±36.38) min, which was longer than that in the open group(117.06±18.72) min(<0.05). The average age of the robot group was(40.25±9.27) years, which was lower than that of the open group(49.59±8.70) years(<0.05). The satisfactory score of cosmetic effect in the robot group(9.44±0.65) was higher than that in the open group(5.23±1.07)(<0.05). There was no significant difference in tumor diameter, BMI, average postoperative drainage, temporary hypoparathyroidism and recurrent laryngeal nerve injury, number of central and lateral cervical lymph node dissection, number of positive lymph nodes in the central and lateral cervical regions, and average postoperative hospital stay between the two groups. There was no permanent hypoparathyroidism and recurrent laryngeal nerve injury in both groups. The application of BABA pathway robot in thyroid cancer surgery in obese women is safe and feasible, and the cosmetic effect is better after operation.

摘要

探讨双侧腋窝-乳房入路(BABA)机器人在肥胖女性甲状腺癌手术中的安全性和可行性。回顾性分析2018年5月至2021年12月在解放军第九六〇医院甲状腺乳腺外科接受达芬奇机器人甲状腺癌手术的81例肥胖女性患者(机器人组)的临床资料,并与同期106例接受开放手术的肥胖女性甲状腺癌患者(开放组)的临床资料进行比较。统计所有患者的年龄、体重指数(BMI)、平均手术时间、平均术后引流量、肿瘤直径、术后肿瘤分期、中央区和侧颈区淋巴结清扫数目、中央区和侧颈区阳性淋巴结数目、术后美容效果满意度评分、平均术后住院时间及术后并发症。采用SPSS 26.0统计软件进行结果分析,计数资料采用²检验,计量资料采用检验。所有患者均成功完成手术,机器人组无中转情况,术后病理结果均为乳头状甲状腺癌。机器人组手术时间为(144.62±36.38)分钟,长于开放组(117.06±18.72)分钟(<0.05)。机器人组平均年龄为(40.25±9.27)岁,低于开放组(49.59±8.70)岁(<0.05)。机器人组美容效果满意度评分(9.44±0.65)高于开放组(5.23±1.07)(<0.05)。两组在肿瘤直径、BMI、平均术后引流量、暂时性甲状旁腺功能减退和喉返神经损伤、中央区和侧颈区淋巴结清扫数目、中央区和侧颈区阳性淋巴结数目以及平均术后住院时间方面差异无统计学意义。两组均无永久性甲状旁腺功能减退和喉返神经损伤。BABA入路机器人应用于肥胖女性甲状腺癌手术安全可行,术后美容效果较好。

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