腔镜辅助与常规甲状腺全切除术后131I清甲疗效的比较

目的:回顾性分析腔镜辅助甲状腺全切除术对甲状腺乳头状癌(PTC)病人接受131I清除残留甲状腺(清甲)治疗的影响,并选择与同期接受常规甲状腺全切除术且病情类似的PTC病人131I清甲资料进行比较。方法:纳入本研究的PTC病人共144例,腔镜辅助甲状腺全切除术后(腔镜组)病人66例,常规甲状腺全切除术后(常规组)病人78例,均住院接受131I清甲治疗。对治疗前超声检查、甲状腺功能指标变化及甲状腺球蛋白、治疗后的131I全身扫描等结果进行评价。采用独立样本t检验比较两组在131I清甲治疗前残留甲状腺的差异;随访时间为4～36个月。卡方检验比较两组131I清甲成功率的差异性。结果:131I清甲治疗前腔镜组及常规组残留甲状腺体积分别为(3.8±1.3)mm3和(3.3±1.0)mm3;两者比较无统计学差异(t=1.17;P=0.25)。单次131I清甲成功率腔镜组为72.7%(48/66);常规组为71.8%(56/78),两组间无统计学差异(χ2=0.015;P=0.901);结论:与常规甲状腺全切除术相比,腔镜辅助下甲状腺全切除术对后续的单次131I清甲疗效没有影响。

Comparison of video-assisted total thyroidectomy with traditional thyroidectomy for postoperative ablation of thyroid remnant with radioiodine-131

Objective This study retrospectively reviewed the outcomes of 131I ablation for thyroid remnant(RAI) after video-assisted thyroidectomy(VAT) in patients with papillary thyroid cancer(PTC),compared with those in PTC patients after conventional thyroidectomy.Methods Of 144 PTC patients undergoing RAI ablation,66 patients were operated with VAT and 78 with conventional thyroidectomy.Thyroid remnants and RAI treatment outcomes were evaluated based on ultrasonography,serum thyroid hormones and thyroidglubin(Tg) levels and post-therapeutical 131I whole body scan.All patients were followed for 4 to 36 months.Results Before RAI treatment,the sizes of thyroid remnant were(3.8±1.3) mm3 in patients with VAT and(3.3±1.0) mm3 in patients with conventional thyroidectomy,repsectively,P>0.05.The efficiency of RAI in VAT group was 72.7%(48/66),similar with that in conventional thyroidectomy group(71.8%,56/78).Conclusions Our study suggests that same outcomes of RAI treatment may be achieved after VAT as conventional thyroidectomy in PTC patients.