甲状腺乳头状癌的开放手术与经胸-乳入路腔镜手术的比较
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摘要
比较甲状腺乳头状癌行传统开放手术与经胸-乳入路内镜手术的效果。收集2014年10月—2017年10月行手术治疗PTC患者573例,其中457例行开放甲状腺切除手术(开放手术组),116例行经胸-乳入路腔镜下甲状腺切除手术(内镜手术组)。对两组临床病理特征、并发症、手术完成情况进行分析。开放手术组平均年龄为47.53岁,内镜手术组为28.33岁(P<0.01);开放手术组手术范围较内镜手术组广泛,但是内镜手术组的手术时间较长(P<0.01);开放手术组平均术后住院时间为9.77 d,内镜手术组为7.31 d(P<0.05);开放手术组的肿瘤直径大于内镜手术组(P<0.05),内镜手术组清除的淋巴结数目较开放手术组少(P<0.01);术后并发症发生率及甲状腺球蛋白水平两组间无显著差异(P>0.05)。内镜手术组的手术切口明显小于开放手术组,且位于隐蔽的部位。经胸-乳入路内镜手术与开放手术治疗PTC手术效果相似,美容效果更好。因此,对选择性的PTC患者行经胸-乳入路腔镜甲状腺切除手术是合适的选择。
引文
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[9] Dralle H, Machens A, Thanh PN. Minimally invasive compared with conventional thyroidectomy for nodular goitre[J]. Best Pract Res Clin Endocrinol Metab, 2014, 28(4):589-599.
[10] Bian XH, Li SJ, Zhou L, et al. Applicability of rapid intraoperative parathyroid hormone assay through fine needle aspiration to identify parathyroid tissue in thyroid surgery[J]. Exp Ther Med, 2016, 12(6):4072-4076.
[12]赵文新,王波,颜守义,等.针式辅助全腔镜甲状腺癌功能性颈淋巴结清扫的策略与技巧[J].腹腔镜外科杂志,2017,22(4):241-245.
[2] Yu HW, Chai YJ, Kwon H, et al. Bilateral axillo-breast approach robotic thyroidectomy[J]. World J Surg, 2017, 41(8):2020-2025.
[3] Duh QY. Presidential Address:minimally invasive endocrine surgery-standard of treatment or hype?[J]. Surgery, 2003, 134(6):849-857.
[4] Miccoli P, Materazzi G, Berti P. Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers:indications and limits[J]. Curr Opin Otolaryngol Head Neck Surg, 2010, 18(2):114-118.
[5] Choi JY, Lee KE, Chung KW, et al. Endoscopic thyroidectomy via bilateral axillo-breast approach(BABA):review of 512 cases in a single institute[J]. Surg Endosc, 2012, 26(4):948-955.
[6] Jeong JJ, Kang SW, Yun JS, et al. Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma(PTMC)patients[J]. J Surg Oncol, 2009, 100(6):477-480.
[7] Lombardi CP, Raffaelli M, De Crea C, et al. Video-assisted versus conventional total thyroidectomy and central compartment neck dissection for papillary thyroid carcinoma[J]. World J Surg. 2012, 36(6):1225-1230.
[8]李志宇,王平,林信斌,等.经胸乳入路内镜手术治疗甲状腺乳头状癌85例临床分析[J].中华普通外科杂志,2011,26(6):485-488.
[9] Dralle H, Machens A, Thanh PN. Minimally invasive compared with conventional thyroidectomy for nodular goitre[J]. Best Pract Res Clin Endocrinol Metab, 2014, 28(4):589-599.
[10] Bian XH, Li SJ, Zhou L, et al. Applicability of rapid intraoperative parathyroid hormone assay through fine needle aspiration to identify parathyroid tissue in thyroid surgery[J]. Exp Ther Med, 2016, 12(6):4072-4076.
[12]赵文新,王波,颜守义,等.针式辅助全腔镜甲状腺癌功能性颈淋巴结清扫的策略与技巧[J].腹腔镜外科杂志,2017,22(4):241-245.