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甲状腺乳头状癌的视频辅助颈部手术的手术结果

Surgical outcomes of video-assisted neck surgery for papillary thyroid carcinoma.

作者信息

Misaki Mariko, Inoue Seiya, Kawakita Naoya, Takeuchi Taihei, Miyamoto Naoki, Sakamoto Shinichi, Fujiwara Satoshi, Goto Masakazu, Tsuboi Mitsuhiro, Toba Hiroaki, Takizawa Hiromitsu

机构信息

Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health, Biosciences, The University of Tokushima, 3-18-15, Kuramoto-Cho, Tokushima, 770-8503, Japan.

Department of Surgery, Tokushima Prefecture Hospital, 1-10-3, Kuramoto-Cho, Tokushima, 770-8539, Japan.

出版信息

Surg Today. 2025 Jan;55(1):29-35. doi: 10.1007/s00595-024-02876-0. Epub 2024 Jun 6.

Abstract

PURPOSE

New approaches to endoscopic thyroid surgery have been developed to improve cosmetic results, one of which is video-assisted neck surgery (VANS). The present study investigates the safety and effectiveness of thyroidectomy by VANS as oncologic surgery for papillary thyroid carcinoma (PTC).

METHODS

The subjects of this retrospective study were 121 patients with PTC, who underwent hemi-thyroid lobectomy and central lymph node dissection via open surgery (n = 102) or VANS (n = 19) at Tokushima University Hospital between 2011 and 2023. We performed 1:1 propensity score matching and then compared the surgical outcomes between the two matched groups.

RESULTS

Propensity score matching generated 18 distinct examination pairs. The VANS group had significantly less blood loss (P = 0.003), but a longer operative time (P < 0.001) than the open thyroidectomy group. There were two cases of transient recurrent laryngeal nerve paralysis and one case of recurrence in the lateral regional lymph nodes in the VANS group. However, no significant differences were observed in the incidence of complications (P = 0.243) or recurrence (P = 0.500) between the two groups.

CONCLUSION

VANS is a safe and effective surgical procedure for PTC, but longer follow-up is needed to assess tumor recurrence.

摘要

目的

为了改善美容效果,已开发出内镜甲状腺手术的新方法,其中之一是视频辅助颈部手术(VANS)。本研究调查了通过VANS进行甲状腺切除术作为乳头状甲状腺癌(PTC)肿瘤手术的安全性和有效性。

方法

本回顾性研究的对象为121例PTC患者,他们于2011年至2023年期间在德岛大学医院接受了半甲状腺叶切除术和中央淋巴结清扫术,其中通过开放手术进行的有102例,通过VANS进行的有19例。我们进行了1:1倾向评分匹配,然后比较了两个匹配组之间的手术结果。

结果

倾向评分匹配产生了18对不同的检查对象。VANS组的失血量明显少于开放甲状腺切除术组(P = 0.003),但手术时间更长(P < 0.001)。VANS组有2例暂时性喉返神经麻痹和1例侧方区域淋巴结复发。然而,两组之间在并发症发生率(P = 0.243)或复发率(P = 0.500)方面未观察到显著差异。

结论

VANS是一种用于PTC的安全有效的手术方法,但需要更长时间的随访来评估肿瘤复发情况。

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