Song Wenhua, Wei Dongmin, Li Wenming, Qian Ye, Chen Dongyan, Xu Chenyang, Zhang Zhouyi, Pan Xinliang, Lei Dapeng
Department of Otorhinolaryngology,Qilu Hospital of Shandong University,National Health;Commission Key Laboratory of Otorhinolaryngology(Shandong University.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Sep;37(9):695-699;707. doi: 10.13201/j.issn.2096-7993.2023.09.003.
To compare the clinical effect of transaxillary non-inflatable endoscopic surgery and traditional open thyroid surgery in the treatment of PTC. A retrospective analysis was performed on 342 patients with PTC treated in the Otorhinolaryngology Department of Qilu Hospital of Shandong University from December 2020 to December 2022. There were 73 males and 269 females, aged 16-72 years, who underwent unilateral non-inflatable transaxillary endoscopic thyroid surgery(endoscopic group) and unilateral traditional open thyroid surgery(open group). There were 108 patients in the endoscopic group and 234 in the open group. The endoscopic group was lower in age(37.1±9.4 vs 43.5±11.2) years and BMI(23.4±3.4 vs 25.7±3.8 )kg/m² than that in the open group, and the difference was statistically significant( was 5.53, 5.67 respectively, <0.01). There was no significant difference in hospitalization days between the two groups(>0.05). The logarithmic curve of the operation time showed a smooth downward trend, and the overall operation time of the endoscopic group was relatively consistent. There was no significant difference in intraoperative blood loss between the endoscopic group(13.3±3.2) mL and the open group(14.7±6.3) mL(>0.05), but the operation time(130.1±37.9) min was longer than that in the open group(57.4±13.7) min, and the difference was statistically significant(=19.40, <0.01). There was no significant difference in complications such as temporary recurrent laryngeal nerve injury within 3 days after operation between the two groups(>0.05). The aesthetic satisfaction score of the surgical incision and the incision concealment effect score in the endoscopic group were higher than those in the open group, and the difference was statistically significant(<0.05). Compared with traditional open thyroidectomy, transaxillary non-inflatable endoscopic thyroidectomy has more advantages in the concealment and aesthetics of postoperative incision. Although the former has longer operation time and more drainage, it is still a safe and feasible surgical method with good postoperative clinical effect.
比较经腋窝非充气式内镜手术与传统开放性甲状腺手术治疗甲状腺乳头状癌(PTC)的临床效果。对2020年12月至2022年12月在山东大学齐鲁医院耳鼻咽喉科接受治疗的342例PTC患者进行回顾性分析。其中男性73例,女性269例,年龄16 - 72岁,分别接受单侧非充气式经腋窝内镜甲状腺手术(内镜组)和单侧传统开放性甲状腺手术(开放组)。内镜组108例,开放组234例。内镜组患者年龄(37.1±9.4 vs 43.5±11.2)岁和体重指数(BMI)(23.4±3.4 vs 25.7±3.8)kg/m²均低于开放组,差异有统计学意义(分别为5.53、5.67,<0.01)。两组患者住院天数差异无统计学意义(>0.05)。手术时间对数曲线呈平滑下降趋势,内镜组总体手术时间相对一致。内镜组术中出血量(13.3±3.2)mL与开放组(14.7±6.3)mL差异无统计学意义(>0.05),但手术时间(130.1±37.9)min长于开放组(57.4±13.7)min,差异有统计学意义(=19.40,<0.01)。两组术后3天内暂时性喉返神经损伤等并发症差异无统计学意义(>0.05)。内镜组手术切口美观满意度评分及切口隐蔽效果评分均高于开放组,差异有统计学意义(<0.05)。与传统开放性甲状腺切除术相比,经腋窝非充气式内镜甲状腺切除术在术后切口隐蔽性和美观性方面具有更多优势。虽然前者手术时间较长、引流较多,但仍是一种安全可行的手术方法,术后临床效果良好。