经腋窝入路与经胸乳入路腔镜单侧甲状腺叶切除的对比研究

目的:对比分析经腋窝入路与胸乳入路腔镜单侧甲状腺叶切除术的临床效果。方法:回顾分析21例经腋窝入路腔镜甲状腺叶切除、25例经胸乳入路腔镜甲状腺叶切除患者的临床资料,对比分析两组手术时间、术中出血量、术后引流量、住院时间、并发症、切口满意度等指标。结果:经腋窝入路手术时间[(129.0±17.91)min]较胸乳入路[(142.0±22.75)min]短,术后引流量[(61.0±43.84)ml]较胸乳入路[(94.0±59.46)ml]少,术后患者对切口满意度较胸乳入路高,差异均有统计学意义(P<0.05);两组术中出血量、术后住院时间、并发症发生率差异无统计学意义。结论:经腋窝入路在处理单侧甲状腺叶疾病方面优于胸乳入路,美容效果较好,两种入路的并发症发生率差异无统计学意义,值得临床推广应用。

Comparative study of endoscopic thyroid lobectomy between axillary approach and chest-breast approach

Objective： To compare the clinical outcomes of endoscopic thyroid lobectomy by axillary approach with chest-breast approach. Methods： The clinical data of endoscopic thyroid lobectomy via axillary approach（ n = 21） and endoscopic thyroid lobectomy by chest-breast approach（ n = 25） were retrospectively analyzed,including operative time,blood loss,drainage,hospital stay,complications and the cosmetic effects. Results： Endoscopic thyroid lobectomy by chest-breast approach cost more time than axillary approach[（ 142. 0 ± 22. 75） min vs.（ 129. 0 ± 17. 91） min） ]; the postoperative drainage of endoscopic thyroid lobectomy by axillary approach[（ 61. 0 ± 43. 84） ml]was less than that of chest-breast approach[（ 94. 0 ± 59. 46） ml]. As for the cosmetic result,the patients in axillary approach group showed more satisfaction than the chest-breast approach group（ P〈0. 05）. There was no significant difference between the two groups in the volume of blood loss during operation,postoperative hospital stay or complication incidence. Conclusions：With better cosmetic effect,axillary approach is better in dealing with unilateral thyroid disease than chest-breast approach,there is no significant difference in the incidence of complications,axillary approach is worth further clinical application.