经口腔前庭入路与经腋窝入路甲状腺切除术对比分析

Comparative Analysis of Transoral Vestibular Approach and Transaxillary Approach for Thyroidectomy

摘要: 目的：对比经口腔前庭入路及经腋窝入路在甲状腺切除术中的可行性。方法：回顾性研究在2019年3月至2023年7月期间，在烟台毓璜顶医院甲状腺外科行经口腔前庭入路甲状腺切除术及经腋窝入路甲状腺切除术的患者资料共546例，其中经口腔前庭入路组448例，经腋窝入路组98例，收集包括性别、年龄、体重指数(BMI)、高血压、冠心病、糖尿病、桥本甲状腺炎、最大肿瘤直径、术后引流量、手术时间、清扫和转移的中央淋巴结数量、并发症的临床数据，探究术式的可行性及安全性。结果：在546例患者的临床资料中，年龄、性别、BMI、中央区淋巴结清扫数量、淋巴结转移数量、术后引流量及手术时间具有统计学差异(P < 0.05)，而高血压、冠心病、糖尿病、桥本甲状腺炎、肿瘤最大直径及术后并发症等并未有统计学意义(P > 0.05)。结论：经口腔前庭入路和经腋窝入路在接受甲状腺切除术的患者术后复发情况及术后并发症方面无显著差异。

Abstract: Objective: To compare the feasibility of gasless endoscopic thyroidectomy transaxillary approach and transoral endoscopic thyroidectomy in thyroidectomy. Methods: The clinical data of 546 patients with thyroid carcinoma who underwent gasless endoscopic thyroidectomy transaxillary approach (n = 98) and transoral endoscopic thyroidectomy (n = 448) in the Department of Thyroid Surgery, Yantai Yuhuangding Hospital from March 2019 to July 2023 were retrospectively analyzed, collecting the basic characteristics such as gender ratio, age, BMI, hypertension, coronary heart disease, diabetes, Hashimoto’s thyroiditis, maximum tumor diameter, postoperative drainage volume, operative time, number of lymph node dissection and metastases in the central region and postoperative complications, to explore the feasibility and safety of the different surgery methods. Results: In the clinical data of 546 patients, age, gender ratio, BMI, number of lymph node dissection and metastases in the central region, postoperative drainage volume and operative time were statistically significant (P < 0.05). There were no significant differences in hypertension, coronary heart disease, diabetes, Hashimoto’s thyroiditis, maximum tumor diameter and postoperative complications between the two groups (P > 0.05). Conclusion: The gasless endoscopic thyroidectomy transaxillary approach and the transoral endoscopic thyroidectomy showed no significant difference in the recurrence and postoperative complications in patients undergoing thyroidectomy.