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克氏针悬吊免充气经颏下-口底内镜甲状腺切除术治疗甲状腺乳头状癌的临床疗效

Clinical efficacy of gasless submental-transoral endoscopic thyroidectomy with Kirschner wire suspension for papillary thyroid carcinoma.

作者信息

Chen Wanzhi, Xie Rong, Zhang Shuyong, Zhou Tao, Xiong Chengfeng, Huang Da, Yu Jichun, Zhong Meijun

机构信息

Department of Thyroid Surgery, The Second Affiliated Hospital of Nanchang University Nanchang 330006, Jiangxi, P. R. China.

The Second Affiliated Hospital of Nanchang University Nanchang 330006, Jiangxi, P. R. China.

出版信息

Am J Transl Res. 2023 Aug 15;15(8):5110-5119. eCollection 2023.

Abstract

PURPOSE

To analyze the clinical efficacy of gasless submental-transoral endoscopic thyroidectomy (ETE) with Kirschner wire suspension in patients with papillary thyroid carcinoma (PTC).

METHODS

Retrospectively, we enrolled 112 patients with PTC who received treatment in The Second Affiliated Hospital of Nanchang University between December 2020 and December 2021. Among them, 60 cases (laparoscopic group) received gasless submental-transoral ETE with Kirschner wire suspension, and the other 52 cases (open group) were treated by traditional thyroidectomy. Surgical indicators (operative time (OT), intraoperative blood loss (IBL), and postoperative drainage volume (DV)), number of central lymph node (CLN) dissected, length of hospital stay (LOS), Visual Analogue Scale (VAS) score, aesthetic satisfaction score, and complications were observed and compared between the two groups.

RESULTS

There was no significant difference between the two groups in OT (55.73±5.49 min vs. 55.00±7.79 min), IBL (20.67±7.75 mL vs. 23.08±6.24 mL), postoperative DV (33.17±15.09 mL vs. 39.52±19.22 mL), number of CLN dissected (5.54±2.75 vs. 5.43±3.15), LOS (3.63±0.69 d vs. 3.68±0.57 d), postoperative VAS score (3.19±1.07 points vs. 3.38±1.09 points), and total complication rate (3.85% vs. 8.33%; all P>0.05). However, the laparoscopic group exhibited a significantly higher aesthetic satisfaction score than the open group (7.10±1.46 points vs. 6.42±1.46 points; P<0.05). In addition, patients in both groups were followed up for at least 3 months, and no recurrence or metastasis was observed.

CONCLUSIONS

Gasless submental-transoral ETE with Kirschner wire suspension offers comparable curative effect as traditional thyroidectomy and safety, but it provides superior esthetic results, making it a viable treatment option for patients with PTC.

摘要

目的

分析无充气经颏下-口内镜甲状腺切除术(ETE)联合克氏针悬吊治疗甲状腺乳头状癌(PTC)患者的临床疗效。

方法

回顾性分析2020年12月至2021年12月在南昌大学第二附属医院接受治疗的112例PTC患者。其中,60例(腹腔镜组)接受无充气经颏下-口ETE联合克氏针悬吊,另外52例(开放组)接受传统甲状腺切除术。观察并比较两组的手术指标(手术时间(OT)、术中出血量(IBL)和术后引流量(DV))、中央淋巴结(CLN)清扫数量、住院时间(LOS)、视觉模拟评分法(VAS)评分、美学满意度评分及并发症。

结果

两组在OT(55.73±5.49分钟 vs. 55.00±7.79分钟)、IBL(20.67±7.75毫升 vs. 23.08±6.24毫升)、术后DV(33.17±15.09毫升 vs. 39.52±19.22毫升)、CLN清扫数量(5.54±2.75 vs. 5.43±3.15)、LOS(3.63±0.69天 vs. 3.68±0.57天)、术后VAS评分(3.19±1.07分 vs. 3.38±1.09分)及总并发症发生率(3.85% vs. 8.33%;均P>0.05)方面无显著差异。然而,腹腔镜组的美学满意度评分显著高于开放组(7.10±1.46分 vs. 6.42±1.46分;P<0.05)。此外,两组患者均至少随访3个月,未观察到复发或转移。

结论

无充气经颏下-口ETE联合克氏针悬吊与传统甲状腺切除术具有相当的疗效和安全性,但美学效果更佳,是PTC患者可行的治疗选择。

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