经胸乳入路腔镜甲状腺手术与传统手术的对比研究

目的:探讨经胸乳入路腔镜甲状腺手术与传统甲状腺手术的优缺点。方法:检索国内数据库,收集关于腔镜甲状腺手术与传统手术对比研究的文献,并手工检索全文,利用Meta分析对所得资料进行对比研究。结果:共7篇文献(879例)符合标准,其中腔镜组435例,传统组444例。通过Meta分析发现,在术中出血量(WMD=-11.98,95%CI:-19.76,-4.21])、患者满意度(WMD=24.62,95%CI:2.55,237.49])、术后镇痛药需求(WMD=0.26,95%CI:0.10,0.64])等方面腔镜组具有明显优势;而术后住院时间(WMD=0.16,95%CI:-0.29,0.60])、引流量(WMD=11.87,95%CI:-3.35,27.10])、并发症(WMD=0.58,95%CI:0.27,1.27])等方面两组差异无统计学意义;手术时间(WMD=24.38,95%CI:11.60,37.17])腔镜组长于传统组。结论:腔镜甲状腺手术可减少术中出血量,提高患者术后满意度,减轻术后疼痛,而在术后住院时间、引流量、并发症等方面与传统手术无明显差异;手术时间长于传统手术。

Comparative study between endoscopic thyroidectomy via breast approach and conventional open thyroidectomy

Objective: To conduct a meta-analysis to explore the merits and disadvantages of endoscopic thyroidectomy via breast approach and conventional open thyroidectomy.Methods: A database searching was performed on CBM,CNKI,Wanfang database and VIP.Comparative studies about endoscopic thyroidectomy via breast approach and conventional open thyroidectomy were selected and analyzed.RevNan 4.2 was used for statistical analysis for the comparative studies.Results: Seven studies matched the selection criteria,which involved 879 patients.435 patients underwent endoscopic thyroidectomy via breast approach(endoscopy group) and 444 patients underwent conventional open thyroidectomy(open group).Comparing the outcomes of endoscopy group with open group,this meta-analysis indicated that endoscopy group was associated with more satisfaction(WMD = 24.62,95% CI 2.55 to 237.49) and more operating time(WMD = 24.38,95% CI 11.60 to 37.17).Drainage fluid(WMD = 11.87,95% CI-3.35 to 27.10),complications(WMD =0.58,95% CI 0.27 to 1.27),and post-operative hospital stay(WMD =0.16,95% CI-0.29 to 0.60) were similar for both procedures.Endoscopy group was associated with lower amount of blood loss in surgery(WMD =-11.98,95% CI-19.76 to-4.21) and less analgesic(WMD = 0.26,95% CI 0.10 to 0.64).Conclusions: Endoscopic thyroidectomy via breast approach can reduce the amount of blood loss in surgery and postoperative pain,it also can improve the satisfaction of patients.There are no differences among drainage fluid,complications and post-operative hospital stay between endoscopic and conventional procedure.In addition,the operating time is longer in endoscopy.