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

目的 分析3D腔镜行甲状腺全切及中央区淋巴结清扫术的临床疗效及对机体炎症反应的影响.方法 回顾性分析90例2013年9月~2016年4月于我院行甲状腺癌根治术患者的临床资料,根据手术方式分为3D腔镜组、2D腔镜组及开放组各30例,比较3组患者围手术期相关临床指标、术后不良反应情况及对机体炎性指标的影响.结果 与开放组、2D腔镜组相比,3D腔镜组术中出血量较少,术后不良反应发生率低.3D组比2D组手术时间短(P<0.05),两组间总住院费用无差异.3D组与其他两组相比术后引流量差异无统计学意义.三者间术后住院时间、淋巴结清扫数、淋巴结阳性率、对机体炎症反应等差异不具统计学意义(P>0.05).结论 3D腔镜下甲状腺全切联合中央区淋巴结清扫术安全、有效,能减少术中出血量、降低围手术期不良反应发生率及对机体炎症反应影响小等优势,可作为分化型甲状腺癌手术的重要选择方式.

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

Objective To analyze the effect of three-dimensional (3D) laparoscopic total thyroidectomy combined with central lymph node dissection for thyroid cancer and its effect on the inflammatory response of the patients. Methods The clinical data were analyzed in 90 patients with thyroid cancer undergoing radical thyroidectomy at our hospital between September, 2013 to April, 2016, including 30 receiving 3D laparoscopic surgeries, 30 with 2D laparoscopic surgeries and 30 with open surgeries. The surgical data, postoperative adverse reactions and the impact of the surgeries on the inflammatory responses of the patients were compared among the 3 groups. Results Compared with the open surgery and 2D laparoscopic surgery, 3D laparoscopic surgery was associated with lowered blood loss during the surgery and a lowered incidence of adverse reactions. The operation time in 3D group was significantly shorter than that in 2D group (P<0.05), but the total hospitalization expenses were similar between the two groups. The postoperative drainage volume did not differ significantly between the 3D group and the other two groups. The postoperative hospital stay, number of lymph nodes dissected, positivity rate of lymph nodes and the inflammatory response showed no significant differences among the 3 groups (P>0.05). Conclusion 3D laparoscopic total thyroidectomy combined with central lymph node dissection is safe and effective and reduces intraoperative blood loss and perioperative adverse reactions without significant influence on inflammatory response in patients with thyroid cancer.