摘要
目的评估和比较甲状腺乳头状癌（PTC）患者行传统开放手术和经全乳晕腔镜手术的效果。方法2012年1月至2017年12月，887例PTC患者接受甲状腺切除术。其中693例（A组）接受传统开放手术，194例（B组）接受腔镜手术。比较两组临床资料、手术方式、肿瘤特征、并发症等。结果A组年龄大于B组[（45.2 ± 11.5）岁比（34.9 ± 9.4）岁，P〈0.01]。B组引流量多于A组，引流管拔除时间也长于A组，差异有统计学意义（P〈0.01）。两组手术类型比较差异有统计学意义（P〈0.01）。B组所有患者成功实行腔镜手术，没有中转开放病例。A组肿瘤大小较B组大（P〈0.01），A组患者中有更多的双侧多灶性肿瘤（P〈0.01）。A组淋巴结清扫数目多，淋巴结转移也更多（P〈0.01）。但进一步对两组患者一侧中央区清扫淋巴结数目进行分析，差异无统计学意义（P=0.162）。两组并发症发生率比较差异无统计学意义（P〉0.05）。结论在严格控制适应证的前提下，选择合适病例行全乳晕入路腔镜甲状腺手术可被视为相对于传统甲状腺手术的可替代外科技术，可满足肿瘤学安全性和美容效果。
Objective To evaluate and compare the surgery prognosis of the papillary thyroid carcinoma （PTC） patients who underwent conventional and endoscopic thyroidectomies via areola.MethodsFrom January 2012 to December 2017, 887 patients with PTC underwent thyroidectomy. The A group of 693 patients underwent traditional thyroidectomy, and B group of 194 patients underwent endoscopic thyroidectomy. Clinicopathologic characteristics, surgical methods, pathological features and complications were analyzed and compared between two groups.ResultsThe mean age of A group was older than B group： （45.2 ± 11.5） years vs. （34.9 ± 9.4） years, P〈0.01. The drainamount and drain maintenance in B group were significantly higher than those in A group （P〈0.01）. The operative methods in two group had significant difference （P〈0.01）. The patients in B group were successful in operation and no one transferred to open operation. The tumor size in the A group was larger than that in B group, and more bilateral multifocal tumors were in A group （P〈0.01）. The number of lymph nodes dissection in A group was more than that in B group （P〈0.01）. There was no significant difference in the postoperative complications （P 〉 0.05）.ConclusionsThe results show that patients with PTC who underwent conventional and endoscopic thyroidectomies via areola have similar surgical prognosis.Therefore, choosing the appropriate cases for endoscopic thyroidectomy via breast areola approach may be regarded as an alternative surgical technique to conventional thyroidectomy which has the oncological safety and cosmetic results.
作者
王中林
饶尚锐
林哲
俞健
潘忠良
Wang Zhonglin;Rao Shangrui;Lin Zhe;Yu Jian;Pan Zhongliang(Department of General Surgery,Wenzhou Central Hospital（Dingli Clinical Institute of Wenzhou Medical University）,Zhejiang Wenzhou 325000,China)
出处
《中国医师进修杂志》
2018年第8期691-695,共5页
Chinese Journal of Postgraduates of Medicine
关键词
甲状腺切除术
内镜
甲状腺乳头状癌
预后
Thyroidectomy
Endoscopy
Papillarythyroid carcinoma
Prognosis
