经口腔前庭腔镜甲状腺癌根治术的临床实践及与开放性手术比较

目的经口腔前庭腔镜甲状腺癌根治术的临床实践及与开放性手术进行比较。方法回顾性收集并比较分析自2019年3月至2019年12月中国科学院大学宁波华美医院甲状腺外科行经口腔前庭腔镜甲状腺切除术和传统开放性甲状腺切除术的甲状腺肿瘤患者各45例临床资料(行经传统开放术式患者样本量较大,随机抽样选择45例),比较分析两组在性别、年龄、BMI、病理类型,清扫淋巴结数量以及手术时长,术后引流量,术后出现相关并发症,远期预后等指标。结果两种术式患者术前术后相关临床资料无明显统计学差异,术中指标如出血量,淋巴清扫方面两组亦无统计学差异,但术中手术时间较开放组延长(P<0.05),手术费用较开放组更多,住院时长较开放组更短。结论选择合适的患者,行经口腔前庭入路腔镜甲状腺癌根治术安全可行,在美容效果上有优势。

The clinical practice of transoral endoscopic thyroidectomy vestibular approachand its comparison with open thyroidectomy

Objective The clinical practice oftransoral endoscopic thyroidectomy vestibular approach（TOETVA） and its comparison with open thyroidectomy. Methods The clinical data of 90 patients of thyroidectomy from March 2019 to December 2019 werecollected and retrospectively analyzed in the Ningbo Huamei hospital, Chinese Academy of Sciences,Department of thyroid surgery. The patients were assigned to TOETVA（45 cases） and conventional open thyroidectomy （the sample size of patients with traditional openthyroidectomy is large, 45 cases were selected by random sampling）, the gender, age, BMI, pathological type, cleaning the number of lymph nodes, and the operative time, postoperative drainage,postoperative complications and associated long-term prognostic indicators were compared. Results There was no statistically significant difference between the two surgical procedures in preoperative and postoperative clinical data,and there was no significant difference in intraoperative indicators such asbleeding volume and lymphatic dissection between the two groups. Butcompared with the open group, the intraoperative operation time was longer （P<0.05）, the operation cost was moreexpensive, and the length of hospitalization time was shorter. Conclusion TOETVA is safe and feasible in selecting suitable patients. It has advantages in cosmetic effect.