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侧入路甲状腺切除术的可行性及临床意义。

The feasibility and clinical significance of lateral approach thyroidectomy.

机构信息

School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong Province, China.

Department of Thyroid and Breast Surgery, Weifang People's Hospital, Weifang, Shandong Province, China.

出版信息

PLoS One. 2024 Mar 22;19(3):e0300604. doi: 10.1371/journal.pone.0300604. eCollection 2024.

Abstract

BACKGROUND

By comparing the three lateral approaches to thyroidectomy, the feasibility and clinical effects were analyzed, and the advantages of the lateral approach were summarized.

METHODS

From January 2022 to January 2023, 52 patients with thyroid cancer admitted to our department were selected and subjected to Lateral approach for thyroidectomy. Among them, 31 patients underwent thyroidectomy via the supraclavicular approach, 13 patients underwent endoscopic thyroidectomy via the subclavicular approach, and 8 patients underwent endoscopic thyroidectomy via the axillary approach. The basic conditions, surgical conditions, complications, postoperative pain scores and postoperative satisfaction of patients in the three approach surgery groups were recorded and analyzed.

RESULTS

There were no significant differences among the three approach groups in terms of patient characteristics, number of central lymph node dissections, intraoperative blood loss, postoperative drainage volume, duration of drainage tube placement, length of hospital stay, postoperative pain, satisfaction, and complications. However, the operation time was longest in the subclavicular approach group, followed by the axillary approach group, and shortest in the supraclavicular approach group. The total hospitalization cost was highest in the axillary approach group, followed by the subclavicular approach group, and lowest in the supraclavicular approach group.

CONCLUSION

The lateral approach for thyroidectomy is deemed a safe and effective method. The three different approach paths gradually increase in length, allowing for the accumulation of anatomical experience. This approach has a shorter learning curve for clinical doctors and is a favorable choice for patients seeking aesthetic benefits.

摘要

背景

通过比较三种甲状腺外侧入路方式,分析其可行性和临床效果,总结外侧入路的优势。

方法

选取 2022 年 1 月至 2023 年 1 月我院收治的 52 例甲状腺癌患者,采用外侧入路行甲状腺切除术,其中经锁骨上入路手术 31 例,经锁骨下入路内镜甲状腺手术 13 例,经腋窝入路内镜甲状腺手术 8 例。记录并分析三组手术患者的基本情况、手术情况、并发症、术后疼痛评分及术后满意度。

结果

三组患者在一般资料、中央区淋巴结清扫数量、术中出血量、术后引流量、引流管留置时间、住院时间、术后疼痛、满意度及并发症方面差异均无统计学意义,而锁骨下入路组手术时间最长,腋窝入路组次之,锁骨上入路组最短;腋窝入路组总住院费用最高,锁骨下入路组次之,锁骨上入路组最低。

结论

甲状腺外侧入路是一种安全有效的手术方法,三种不同的入路方式逐渐增加手术长度,积累解剖经验,对于临床医生来说具有较短的学习曲线,是寻求美容效果的患者的良好选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c15/10959362/d53079a360ea/pone.0300604.g001.jpg

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