经胸乳入路腔镜甲状腺微小乳头状癌切除术与传统开放手术的对比研究

目的:探讨经胸乳入路腔镜甲状腺微小乳头状癌切除术与传统开放手术的临床效果、安全性及卫生经济学.方法:回顾分析2018年9月至2020年8月收治的44例甲状腺微小乳头状癌患者的临床资料,其中21例(腔镜组)行经胸乳入路腔镜甲状腺微小乳头状癌切除术,23例(开放组)行甲状腺微小乳头状癌传统开放手术,对比分析两组患者性别、年...

A comparative study of endoscopic thyroidectomy via breast approach and conventional open thyroid surgery for papillary thyroid microcarcinoma

Objective:To investigate clinical efficacy,safety and health economics between endoscopic thyroidectomy via breast approach and conventional open thyroid surgery for papillary thyroid microcarcinoma.Methods:Retrospective analysis was performed on the clinical data of 44 cases of papillary thyroid microcarcinoma admitted to the same operation group from Sep.2018 to Aug.2020.Among them,21 cases(endoscopic group)underwent endoscopic thyroidectomy via breast approach,and 23 cases(open group)underwent conventional open thyroid surgery.Analysis and comparison was made between the two groups on the gender,age,maximum pathological diameter of tumor,the number of tumors,tumor side,whether Hashimoto's thyroiditis was combined,operation duration,intraoperative blood loss,the number of lymph nodes dissection,total drainage volume,drainage tube removal time,postoperative hospital stay,operation cost,total cost and the occurrence of postoperative complications.Visual analogue scale was used to evaluate the pain on the first day after surgery.A questionnaire was used to evaluate patients'aesthetic satisfaction with the incision 3 months after surgery.Results:Compared with the open group,the age of the endoscopic group was younger,the duration of surgery and drainage tube removal time were longer,the total postoperative drainage volume,operation cost and total cost were more,but the incision aesthetic satisfaction was higher(P<0.05);However,there were no statistically significant differences between the two groups in terms of gender,maximum pathological diameter of tumor,the number of tumors,tumor side,whether Hashimoto's thyroiditis was combined,the amount of intraoperative blood loss,the number of lymph nodes dissection,the pain score on the first day after surgery,the postoperative hospital stay and the occurrence of postoperative complications(P>0.05).Conclusions:Younger patients with higher cosmetic requirements are more likely to undergo endoscopic thyroidectomy via breast approach,which can be the first choice for patients with papillary thyroid microcarcinoma when economic conditions permit and cosmetic needs arise.