全乳晕入路腔镜甲状腺切除术的疗效分析
|
摘要
目的:比较腔镜下甲状腺切除术与开放性甲状腺切除术的疗效。方法:我院2017年1月至2018年1月收治107例甲状腺良性病变患者,按照不同的手术方法将其分为研究组(37例)和对照组(70例)。前者行完全乳晕入路腔镜下甲状腺切除术,后者予以常规开放入路甲状腺切除术。结果:研究组中36例顺利完成手术,1例术中腔镜中转开放手术;对照组中70例均顺利完成手术。研究组术中出血量、切口引流量以及引流管放置时间明显少于对照组,研究组术后并发症发生率明显低于对照组,研究组手术美容效果总满意度明显高于对照组,差异均有统计学意义(P <0. 05),研究组与对照组的手术时间、术后VAS疼痛评分差异无统计学意义(P> 0. 05)。结论:腔镜下甲状腺切除术可以有效治疗甲状腺良性疾病,其术中出血量少,切口引流量少,并发症少,美容效果好,是安全可行的手术方式。
Objective: To compare the effect of endoscopic thyroidectomy and open thyroidectomy in the treatment of patients with thyroid tumor. Methods: A retrospective study was conducted to select 107 patients with benign thyroid lesions admitted to our hospital from January 2017 to January 2018. They were divided into study group( 37 cases) and control group( 70 cases) according to different surgical methods. The former underwent endoscopic thyroidectomy through complete areola approach,while the latter underwent conventional open thyroidectomy. Results: In the study group,36 cases were successfully operated,1 case was converted to open surgery by endoscopy,and 70 cases in the control group were successfully operated. The intraoperative bleeding volume,incision drainage volume and drainage tube placement time in the study group were significantly less than those in the control group. The postoperative complication rate in the study group was significantly lower than that in the control group. The overall satisfaction of the researcher was significantly higher than that in the control group( P < 0. 05). The difference was statistically significant( P < 0. 05). The operation timebetween the two groups and the VAS pain score after operation were not statistically significant( P > 0. 05).Conclusions: Endoscopic thyroidectomy can effectively treat benign thyroid diseases. It has less intraoperative blood loss,less postoperative drainage,fewer complications,and good cosmetic results. It is a safe and feasible surgical method.
Objective: To compare the effect of endoscopic thyroidectomy and open thyroidectomy in the treatment of patients with thyroid tumor. Methods: A retrospective study was conducted to select 107 patients with benign thyroid lesions admitted to our hospital from January 2017 to January 2018. They were divided into study group( 37 cases) and control group( 70 cases) according to different surgical methods. The former underwent endoscopic thyroidectomy through complete areola approach,while the latter underwent conventional open thyroidectomy. Results: In the study group,36 cases were successfully operated,1 case was converted to open surgery by endoscopy,and 70 cases in the control group were successfully operated. The intraoperative bleeding volume,incision drainage volume and drainage tube placement time in the study group were significantly less than those in the control group. The postoperative complication rate in the study group was significantly lower than that in the control group. The overall satisfaction of the researcher was significantly higher than that in the control group( P < 0. 05). The difference was statistically significant( P < 0. 05). The operation timebetween the two groups and the VAS pain score after operation were not statistically significant( P > 0. 05).Conclusions: Endoscopic thyroidectomy can effectively treat benign thyroid diseases. It has less intraoperative blood loss,less postoperative drainage,fewer complications,and good cosmetic results. It is a safe and feasible surgical method.
引文
[1]Fan X,Wu Q,Li Y,et al.Association between adiponectin concentrations and diabetic retinopathy in patients with type 2 diabetes:a meta analysis[J].Chin Med J(Engl),2014,127(4):765-771.
[2]Luo YY,Zhao J,Han XY,et al.Relationship Between Serum Zinc Level and Microvascular Complications in Patients with Type 2 Diabetes[J].Chin Med J(Engl),2015,128(24):3276-3282.
[3]邹兆伟,黄宗海,李强,等.3D腹腔镜在经胸乳入路甲状腺次全切除术中的临床效果[J].南方医科大学学报,2014,(8):1233-1235.
[4]Wang C,Sun P,Li J,et al.Strategies of laparoscopic thyroidectomy for treatment of substernal goiter via areola approach[J].Surg Endosc,2016,30(11):4721-4730.
[5]鲁瑶,刘军,杨猛,等.经胸乳入路内镜手术治疗甲亢的疗效及技术难点[J].腹腔镜外科杂志,2011(11):804-806.
[6]卢强,谢书勤,李君久,等.完全乳晕入路与胸乳入路腔镜甲状腺切除术的比较研究[J].宁夏医学杂志,2015(8):691-693.
[7]苏艳军,程若川.程序化甲状腺叶切除术的基本问题[J].国际外科学杂志,2015(1):1-3.
[8]刘佳,仇明.腔镜与开放性甲状腺肿瘤切除术的疗效比较[J].实用临床医药杂志,2018(1):77-79.
[9]Al-Habsi A,Al-Sulaimani A,Taqi K,et al.Comparison of Postoperative Drain Insertion versus No Drain Insertion in Thyroidectomies:Retrospective case-control study from the Sultan Qaboos University Hospital,Muscat,Oman[J].Sultan Qaboos University Medical Journal,2016,16(4):464-468.
[10]Ohgami M,Ishii S,Arisawa Y,et al.Scarless endoscopic thyroidectomy:breast approach for better cosmesis[J].Surg Laparosc Endosc Percutan Tech,2000,10(1):1-4.
[11]韩月锋,李灿,梁志宏,等.乳晕入路腔镜甲状腺切除术与传统甲状腺切除术的术后并发症对比研究[J].中华普通外科杂志,2016(7):561-564.
[12]赵洪远,曾峰,程晓明,等.全乳晕入路甲状腺腔镜手术与传统开放性手术对比分析[J].临床耳鼻咽喉头颈外科杂志,2016(10):815-817.
[2]Luo YY,Zhao J,Han XY,et al.Relationship Between Serum Zinc Level and Microvascular Complications in Patients with Type 2 Diabetes[J].Chin Med J(Engl),2015,128(24):3276-3282.
[3]邹兆伟,黄宗海,李强,等.3D腹腔镜在经胸乳入路甲状腺次全切除术中的临床效果[J].南方医科大学学报,2014,(8):1233-1235.
[4]Wang C,Sun P,Li J,et al.Strategies of laparoscopic thyroidectomy for treatment of substernal goiter via areola approach[J].Surg Endosc,2016,30(11):4721-4730.
[5]鲁瑶,刘军,杨猛,等.经胸乳入路内镜手术治疗甲亢的疗效及技术难点[J].腹腔镜外科杂志,2011(11):804-806.
[6]卢强,谢书勤,李君久,等.完全乳晕入路与胸乳入路腔镜甲状腺切除术的比较研究[J].宁夏医学杂志,2015(8):691-693.
[7]苏艳军,程若川.程序化甲状腺叶切除术的基本问题[J].国际外科学杂志,2015(1):1-3.
[8]刘佳,仇明.腔镜与开放性甲状腺肿瘤切除术的疗效比较[J].实用临床医药杂志,2018(1):77-79.
[9]Al-Habsi A,Al-Sulaimani A,Taqi K,et al.Comparison of Postoperative Drain Insertion versus No Drain Insertion in Thyroidectomies:Retrospective case-control study from the Sultan Qaboos University Hospital,Muscat,Oman[J].Sultan Qaboos University Medical Journal,2016,16(4):464-468.
[10]Ohgami M,Ishii S,Arisawa Y,et al.Scarless endoscopic thyroidectomy:breast approach for better cosmesis[J].Surg Laparosc Endosc Percutan Tech,2000,10(1):1-4.
[11]韩月锋,李灿,梁志宏,等.乳晕入路腔镜甲状腺切除术与传统甲状腺切除术的术后并发症对比研究[J].中华普通外科杂志,2016(7):561-564.
[12]赵洪远,曾峰,程晓明,等.全乳晕入路甲状腺腔镜手术与传统开放性手术对比分析[J].临床耳鼻咽喉头颈外科杂志,2016(10):815-817.