两种经腋窝入路腔镜单孔甲状腺手术的临床疗效对比研究

目的对比改良无充气腋窝入路与常规经腋窝入路腔镜单孔甲状腺手术的临床效果。方法前瞻性研究2019年1月至2020年6月的62例行甲状腺肿瘤切除术的患者,数字随机法分为两组,行常规单孔腔镜腋窝入路甲状腺手术(常规组)31例,行改良无充气腋窝入路甲状腺手术(改良组)31例,采用软件SPSS 23.0进行统计学分析。两组围术期指标、切口疼痛评分、美容满意度评分等计量资料采用(x±s)表示,采用独立t检验;并发症等计数资料采用χ²检验分析。P<0.05表示差异有统计学意义。结果两组患者手术时间、术后引流量、引流管拔除时间、平均住院时间差异均无统计学意义(P>0.05);改良组并发症发生率明显低于常规组(6.5% vs.32.3%,P<0.05),术后3 d、5 d、15d改良组患者切口疼痛评分均显著低于常规组(P<0.05),术后切口美容满意度评分显著高于常规组(P<0.05),随访4~17个月,所有患者均未出现病情复发和转移情况。结论改良无充气腋窝入路应用于甲状腺手术具有视野清晰、并发症少、美容效果好等优势,但两种手术方式均安全可行。

Comparative study on clinical effects of two kinds of endoscopic single-port thyroid surgery via axillary approach

Objective To compare the clinical effect of modified non-inflatable axillary approach and conventional transaxillary endoscopic single hole thyroid surgery.Methods A prospective study of 62 patients who underwent thyroid tumor resection from January 2019 to June 2020 were divided into two groups:31 patients who received routine single-hole endoscopic thyroid surgery via axillary approach(conventional group)and 31 patients who received modified non-aerated axillary approach(improved group).SPSS23.0 was used for statistical analysis.Perioperative indicators,incision pain score,aesthetic satisfaction score and other measurement data of the two groups were represented by(x±s),and independent T test was used.Statistical data of complications were analyzed byχ²test,P<0.05 indicated statistically significant difference.Results There were no significant differences in operative time,postoperative drainage volume,drainage tube removal time and average hospital stay between 2 groups(P>0.05);The complication rate in the modified group was significantly lower than that in the conventional group(6.5%vs.32.3%,P<0.05),the incision pain score in the modified group was significantly lower than that in the conventional group at 3 d,5 d and 15 d after surgery(P<0.05),and the incision aesthetic satisfaction score was significantly higher than that in the conventional group(P<0.05).The follow-up period was 4~17 months,no recurrence or metastasis occurred in all patients.Conclusion The modified air-free axillary approach in thyroid surgery has the advantages of clear vision,less complications and good cosmetic effect,but the two surgical methods are safe and feasible.