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经锁骨下途径免气腹内镜甲状腺切除术治疗单侧乳头状甲状腺癌的疗效

The efficacy of gasless endoscopic thyroidectomy via trans-subclavian approach in unilateral papillary thyroid carcinoma.

作者信息

Yin Xiangdang, Fu Jingyao, Zhang Zhe, Zhang Rui, Li Zhaojun, Song Liyou, Jin Tong, Wang Xudong

机构信息

Department of Head and Neck Oncology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Basic and Translational Medicine on Head & Neck Cancer, Tianjin, China.

Key Laboratory of Cancer Prevention and Therapy, Tianjin Cancer Institute National Clinical Research Center of Cancer, Tianjin, China.

出版信息

Front Endocrinol (Lausanne). 2025 Aug 27;16:1621481. doi: 10.3389/fendo.2025.1621481. eCollection 2025.

Abstract

OBJECTIVE

To evaluate the efficacy of gasless endoscopic thyroidectomy via the trans-subclavian approach in treating unilateral papillary thyroid carcinoma.

METHODS

A retrospective analysis was conducted on 140 patients who underwent surgical treatment for unilateral papillary thyroid carcinoma at the Department of Oral-Maxillofacial-Thyroid Oncosurgery, Jilin Cancer Hospital, between February 2023 and August 2024. Patients were divided into the endoscopic (n=70) and open surgery group (n=70). Clinical characteristics, surgical indicators (operation time, number of central lymph node dissections, intraoperative blood loss, 24-hour postoperative drainage volume, indwelling time of drainage tube, surgical cost, length of hospital stay), complication rates, neck discomfort, and incision satisfaction were compared.

RESULTS

Patients in the endoscopic group were younger and had a higher proportion of women (p<0.05). The endoscopic group showed significantly longer operation times and higher 24-hour drainage volumes (p<0.05). No substantial differences were observed between groups in intraoperative blood loss, lymph node dissection count, drainage tube retention time, length of hospital stay, surgical cost, and postoperative complication rates (p>0.05). Neck discomfort was considerably lower, and incision satisfaction was significantly higher in the endoscopic group (p < 0.05).

CONCLUSION

Gasless endoscopic thyroidectomy via the trans-subclavian approach is a safe and effective treatment for unilateral papillary thyroid carcinoma. It reduces postoperative neck discomfort and improves cosmetic outcomes, making it a viable and promotable surgical option.

摘要

目的

评估经锁骨下途径免气腹内镜甲状腺切除术治疗单侧甲状腺乳头状癌的疗效。

方法

回顾性分析2023年2月至2024年8月在吉林省肿瘤医院口腔颌面-甲状腺肿瘤外科接受单侧甲状腺乳头状癌手术治疗的140例患者。将患者分为内镜手术组(n = 70)和开放手术组(n = 70)。比较两组患者的临床特征、手术指标(手术时间、中央区淋巴结清扫数目、术中出血量、术后24小时引流量、引流管留置时间、手术费用、住院时间)、并发症发生率、颈部不适情况及切口满意度。

结果

内镜手术组患者年龄较轻,女性比例较高(p<0.05)。内镜手术组手术时间明显更长,24小时引流量更多(p<0.05)。两组在术中出血量、淋巴结清扫数目、引流管留置时间、住院时间、手术费用及术后并发症发生率方面差异无统计学意义(p > 0.05)。内镜手术组颈部不适明显较轻,切口满意度明显更高(p < 0.05)。

结论

经锁骨下途径免气腹内镜甲状腺切除术是治疗单侧甲状腺乳头状癌的一种安全有效的方法。它可减轻术后颈部不适,改善美容效果,是一种可行且值得推广的手术选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/243f/12420322/b28a0f92ad57/fendo-16-1621481-g001.jpg

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