经乳晕入路腔镜下甲状腺癌切除术对甲状腺癌患者术中出血量和并发症的影响

Impacts of endoscopic thyroidectomy through the areola approach on intraoperative bleeding and complications in patients with thyroid carcinoma

摘要:

目的 分析经乳晕入路腔镜下甲状腺癌切除术治疗甲状腺癌的有效性和安全性。方法 选择2020年1月－2022年6月该院收治的甲状腺癌患者100例，按随机数表法分为A组（n = 50，经腋窝入路腔镜下甲状腺癌切除术）和B组（n = 50，经乳晕入路腔镜下甲状腺癌切除术）。比较两组患者术中指标、术后指标、美学效果、并发症和生存率。结果 B组手术时间较A组长，术中出血量和术后引流量较A组多，差异均有统计学意义（P < 0.05）；两组患者淋巴结清扫数目、术后拔管时间、住院时间、温哥华瘢痕评估量表（VSS）评分、生存率和并发症总发生率比较，差异均无统计学意义（P > 0.05）。结论 经乳晕入路腔镜下甲状腺癌切除术，在淋巴结清扫数目、术后拔管时间、住院时间、美学效果、并发症和生存率方面与经腋窝入路腔镜下甲状腺癌切除术相近，但手术时间更长，术中出血量更大，术后引流量也更多。临床可根据实际情况，选择合适的手术入路。

Abstract:

Objective To analyze the effectiveness and safety of endoscopic thyroidectomy through the areola approach for thyroid carcinoma.Methods From January 2020 to June 2022, 100 patients with thyroid carcinoma were grouped into group A (n = 50, endoscopic thyroidectomy via axillary approach) and group B (n = 50, endoscopic thyroidectomy via areola approach) using a random number table method. The intraoperative and postoperative indicators, aesthetic effects, complications, and survival rate of the two groups were compared.Results The surgical time of group B was longer than that of group A, the intraoperative bleeding and postoperative drainage volume were more than those of group A, the differences were statistically significant (P < 0.05); There was no statistically obvious difference in the number of lymph node dissections, postoperative extubation time, length of hospital stay, Vancouver scar scale (VSS) score, survival rate, and total incidence of complications between the two grousps (P > 0.05).Conclusion Endoscopic thyroidectomy through the areola approach for thyroid carcinoma is similar to endoscopic thyroidectomy through the axillary approach in terms of the number of lymph node dissections, postoperative extubation time, hospital stay, aesthetic effect, complications, and survival rate, but the operation time is longer, the intraoperative blood loss is more, and the postoperative drainage is also more. Clinically, the appropriate surgical approach can be selected according to the actual situation.