经胸锁乳突肌肌间入路甲状腺癌根治手术的临床观察

目的:探讨颈侧切口经胸锁乳突肌肌间入路（腔镜辅助）实施甲状腺癌根治手术的可行性和安全性。方法:选择2018年1月-2019 年9月我院普外科收治的甲状腺恶性结节患者共60例。按照随机数字表法分为两组，每组各30 例。观察组采用颈侧切口经胸锁乳突肌肌间入路（腔镜辅助）实施甲状腺癌根治手术。对照组采用颈前切口颈白线入路实施甲状腺癌根治手术。比较两组手术时间、术中出血量、术后切口疼痛评分、美容满意度、术后住院时间、并发症等指标。结果:观察组在美容满意度、术后疼痛评分、并发症方面要明显优于对照组，其差异有统计学意义。两组在手术时间、术中出血量、术后住院时间方面的比较无明显统计学意义。结论:颈侧切口经胸锁乳突肌肌间入路（腔镜辅助）实施甲状腺癌根治手术要明显优于传统的颈前切口颈白线入路，更值得在临床上推广及实施。

Clinical observation of radical thyroidectomy through intramuscular approach of sternocleidomastoid muscle

Objective:To explore the feasibility and safety of radical thyroidectomy using the intramuscular approach of sternocleidomastoid muscle through lateral neck incision(assisted by endoscopy).Methods:A total of 60 cases of malignant thyroid nodules were selected from January 2018 to September 2019 in our hospital.According to the method of random number table，the patients were divided into two groups，with 30 cases in each group.In the observation group，radical thyroidectomy was performed using the intramuscular approach of sternocleidomastoid muscle through lateral neck incision(assisted by endoscopy).In the control group，radical thyroidectomy was performed using the neck white line approach through the anterior neck incision.The operation time，intraoperative blood loss，postoperative incision pain score，cosmetic satisfaction，postoperative hospital stay，and complications were compared between the two groups.Results:The observation group was significantly better than the control group in terms of cosmetic satisfaction，postoperative pain score，and complications，and the differences were statistically significant.There was no statistically significant difference between the two groups in terms of operation time，intraoperative blood loss and postoperative hospital stay.Conclusion:Radical thyroidectomy using the intramuscular approach of sternocleidomastoid muscle through lateral neck incision(assisted by endoscopy) is more worthy of clinical promotion and implementation.