经胸壁入路3D与2D腹腔镜根治术治疗甲状腺癌的近期疗效及生存质量比较
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摘要
目的探讨经胸壁入路3D与2D腹腔镜根治术治疗甲状腺癌的近期疗效及生存质量。方法将收治的120例甲状腺癌患者随机分为3D腹腔镜组和2D腹腔镜组,各60例,分别给予相应的治疗方案,观察两组患者治疗的近期疗效及生存质量差异。采用SPSS23.0统计学软件,两组患者治疗有效率、并发症发生率采用卡方检验比较; TI-RADS评分、血清TSH、FT3、FT4及SF-36生活质量评分采用独立t检验,P<0.05则有统计学意义。结果 3D组治疗有效率、生活质量显著高于2D组,治疗后并发症发生率、血清TSH、FT3、FT4均低于2D组(P<0.05)。结论经胸壁入路3D腹腔镜根治术治疗甲状腺癌具有更好的近期疗效,可有效改善患者生存质量。
Objective To evaluate the short-term efficacy and life quality of 3 D and 2 D laparoscopic radical resection for thyroid cancer. Methods 120 patients with thyroid cancer were randomly divided into 3 D laparoscopy group and 2 D laparoscope group, and 60 cases in each group according to the treatment plan. The differences of short-term curative effect and the quality of life were observed in the two groups. SPSS23.0 statistics software was used. The treatment efficiency and incidence of complications between the two groups were compared by chi square. TI-RADS score, serum TSH, FT3, FT4 and SF-36 quality score were compared by independent t test, and P<0.05 had statistical significance.Results The effective rate of treatment and the quality of life of SF-36 in group 3 D were significantly higher than that in group 2 D, and the incidence of complications after treatment was significantly lower than that in group 2 D. The serum TSH, FT3 and FT4 were lower than those in the 2 D group, and all the differences were statistically significant(P<0.05). Conclusion 3 D laparoscopic radical resection through chest wall approach has a better short-term effect in the treatment of thyroid cancer, and can effectively improve the quality of life of patients.
Objective To evaluate the short-term efficacy and life quality of 3 D and 2 D laparoscopic radical resection for thyroid cancer. Methods 120 patients with thyroid cancer were randomly divided into 3 D laparoscopy group and 2 D laparoscope group, and 60 cases in each group according to the treatment plan. The differences of short-term curative effect and the quality of life were observed in the two groups. SPSS23.0 statistics software was used. The treatment efficiency and incidence of complications between the two groups were compared by chi square. TI-RADS score, serum TSH, FT3, FT4 and SF-36 quality score were compared by independent t test, and P<0.05 had statistical significance.Results The effective rate of treatment and the quality of life of SF-36 in group 3 D were significantly higher than that in group 2 D, and the incidence of complications after treatment was significantly lower than that in group 2 D. The serum TSH, FT3 and FT4 were lower than those in the 2 D group, and all the differences were statistically significant(P<0.05). Conclusion 3 D laparoscopic radical resection through chest wall approach has a better short-term effect in the treatment of thyroid cancer, and can effectively improve the quality of life of patients.
引文
[1] 柳学文,李强,陈飞,等.3D腔镜在甲状腺全切及中央区淋巴结清扫术中的临床效果[J].南方医科大学学报,2017,37(6):842-846.
[2] Su A,Gong Y,Wu W,et al.Effect of autotransplantation of a parathyroid gland on hypoparathyroidism after total thyroidectomy[J].Endocrine Connections,2018,7(2):286-294.
[3] 柳学文.3D腔镜技术在分化型甲状腺癌手术中的临床应用研究[D].广州:南方医科大学,2017:1-53.
[4] Knight S,Aggarwal R,Agostini A,et al.Development of an objective assessment tool for total laparoscopic hysterectomy:A Delphi method among experts and evaluation on a virtual reality simulator[J].Plos One,2018,13(1):e0190580- e0190580.
[5] 仉志军,杨兴旺,杨春晓,等.腹腔镜下改良淋巴结清扫术在甲状腺癌中的应用价值[J/CD].中华普外科手术学杂志:电子版,2016,10(3):228-230.
[6] Liu XW,Li Q,Chen F,et al.Efficacy of three-dimensional laparoscopic total thyroidectomy combined with central lymph node dissection for thyroid cancer and its effect on inflammatory responses of the patients[J].Nan Fang Yi Ke Da Xue Xue Bao,2017,37(6):842-846.
[7] 郑庆生,李军政,洪伟雄,等.经胸乳入路腹腔镜下改良淋巴结清扫术在甲状腺癌中的应用价值[J].中国医学创新,2016,13(10):30-32.
[8] Choi YJ,Lee JH,Lee CR,et al.Laparoscopic total pancreatectomy for multiple metastasis of renal cell carcinoma of the pancreas:a case report and literature review[J].Ann Hepatobiliary Pancreat Surg,2017,21(2):96-100.
[9] Sewefy AM,Tohamy TA,Esmael TM,et al.Intra-capsular total thyroid enucleation versus total thyroidectomy in treatment of benign multinodular goiter.A prospective randomized controlled clinical trial[J].Int J Surg,2017,45:29-34.
[10] 黎东伟,李君久,熊秋华,等.3D与2D腹腔镜在甲状腺切除术中的对比研究[J].中国微创外科杂志,2018,18(1):29-32.
[11] Rege SA.Peer review report 1 on “Advanced Vessel Sealing Devices in Total Thyroidectomy for Substernal Goitre:A Cross-sectional Study”[J].International Journal of Surgery,2017,37(1):53-61.
[12] 左富义,孙亮,聂玉辉,等.腔镜下全甲状腺切除术[J/CD].中华普外科手术学杂志(电子版),2018,12(1):22-22.
[13] 王燕,潘在用,林志刚.促甲状腺激素抑制疗法对老年甲状腺癌患者免疫功能及血清CD44V6、FT3、FT4水平的影响[J].中国老年学杂志,2018,38(5):1110-1113.
[14] Chung PJ,Lee M,Chang EH,et al.Does Specialty Matter?Analysis of Outcomes in Total Thyroidectomy for Goiters Between General Surgery and Otolaryngology Using American College of Surgeons NSQIP[J].Journal of the American College of Surgeons,2017,225(4):S68-S75.
[15] 王惟,张达容,黄煜琪,等.甲状腺癌患者血清IL-17、IL-35、SIL-2R表达水平及其临床意义[J].现代生物医学进展,2018,18(4):729-732.
[16] 张力丹,席永昌,尤立强,等.TSH抑制疗法对分化型甲状腺癌患者术后血清Tg、VEGF、TSGF、CD44V6、sIL-2R及T淋巴细胞亚群水平的影响[J].海南医学院学报,2018,24(2):242-245.
[17] Tyutyunnik P,Khatkov I,Tsvirkun V,et al.One hundred and fifty total laparoscopic pancreatoduodenectomy for patients with tumors of the head of the pancreas and the periampullare area[J].Pancreatology,2017,17(3):S101-S102.
[18] 许建利,孟建永.血清中TSH、HIF-1α浓度和分化型甲状腺癌患者颈淋巴结转移的关系[J].世界最新医学信息文摘,2017,17(45):120-120,122.
[2] Su A,Gong Y,Wu W,et al.Effect of autotransplantation of a parathyroid gland on hypoparathyroidism after total thyroidectomy[J].Endocrine Connections,2018,7(2):286-294.
[3] 柳学文.3D腔镜技术在分化型甲状腺癌手术中的临床应用研究[D].广州:南方医科大学,2017:1-53.
[4] Knight S,Aggarwal R,Agostini A,et al.Development of an objective assessment tool for total laparoscopic hysterectomy:A Delphi method among experts and evaluation on a virtual reality simulator[J].Plos One,2018,13(1):e0190580- e0190580.
[5] 仉志军,杨兴旺,杨春晓,等.腹腔镜下改良淋巴结清扫术在甲状腺癌中的应用价值[J/CD].中华普外科手术学杂志:电子版,2016,10(3):228-230.
[6] Liu XW,Li Q,Chen F,et al.Efficacy of three-dimensional laparoscopic total thyroidectomy combined with central lymph node dissection for thyroid cancer and its effect on inflammatory responses of the patients[J].Nan Fang Yi Ke Da Xue Xue Bao,2017,37(6):842-846.
[7] 郑庆生,李军政,洪伟雄,等.经胸乳入路腹腔镜下改良淋巴结清扫术在甲状腺癌中的应用价值[J].中国医学创新,2016,13(10):30-32.
[8] Choi YJ,Lee JH,Lee CR,et al.Laparoscopic total pancreatectomy for multiple metastasis of renal cell carcinoma of the pancreas:a case report and literature review[J].Ann Hepatobiliary Pancreat Surg,2017,21(2):96-100.
[9] Sewefy AM,Tohamy TA,Esmael TM,et al.Intra-capsular total thyroid enucleation versus total thyroidectomy in treatment of benign multinodular goiter.A prospective randomized controlled clinical trial[J].Int J Surg,2017,45:29-34.
[10] 黎东伟,李君久,熊秋华,等.3D与2D腹腔镜在甲状腺切除术中的对比研究[J].中国微创外科杂志,2018,18(1):29-32.
[11] Rege SA.Peer review report 1 on “Advanced Vessel Sealing Devices in Total Thyroidectomy for Substernal Goitre:A Cross-sectional Study”[J].International Journal of Surgery,2017,37(1):53-61.
[12] 左富义,孙亮,聂玉辉,等.腔镜下全甲状腺切除术[J/CD].中华普外科手术学杂志(电子版),2018,12(1):22-22.
[13] 王燕,潘在用,林志刚.促甲状腺激素抑制疗法对老年甲状腺癌患者免疫功能及血清CD44V6、FT3、FT4水平的影响[J].中国老年学杂志,2018,38(5):1110-1113.
[14] Chung PJ,Lee M,Chang EH,et al.Does Specialty Matter?Analysis of Outcomes in Total Thyroidectomy for Goiters Between General Surgery and Otolaryngology Using American College of Surgeons NSQIP[J].Journal of the American College of Surgeons,2017,225(4):S68-S75.
[15] 王惟,张达容,黄煜琪,等.甲状腺癌患者血清IL-17、IL-35、SIL-2R表达水平及其临床意义[J].现代生物医学进展,2018,18(4):729-732.
[16] 张力丹,席永昌,尤立强,等.TSH抑制疗法对分化型甲状腺癌患者术后血清Tg、VEGF、TSGF、CD44V6、sIL-2R及T淋巴细胞亚群水平的影响[J].海南医学院学报,2018,24(2):242-245.
[17] Tyutyunnik P,Khatkov I,Tsvirkun V,et al.One hundred and fifty total laparoscopic pancreatoduodenectomy for patients with tumors of the head of the pancreas and the periampullare area[J].Pancreatology,2017,17(3):S101-S102.
[18] 许建利,孟建永.血清中TSH、HIF-1α浓度和分化型甲状腺癌患者颈淋巴结转移的关系[J].世界最新医学信息文摘,2017,17(45):120-120,122.