[1]傅锦波,罗晔哲,洪晓泉,等.经腋窝入路与经胸乳入路腔镜甲状腺切除术的对比研究[J].中国微创外科杂志,2017,17(08):688-690.
　Fu Jinbo,Luo Yezhe,Hong Xiaoquan,et al.A Comparative Study of Axillary Approach Versus Breast Approach for Endoscopic Thyroidectomy[J].Chinese Journal of Minimally Invasive Surgery,2017,17(08):688-690.
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经腋窝入路与经胸乳入路腔镜甲状腺切除术的对比研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年08期
页码:
688-690
栏目:
临床论著
出版日期:
2017-08-20

文章信息/Info

Title:
A Comparative Study of Axillary Approach Versus Breast Approach for Endoscopic Thyroidectomy
作者:
傅锦波; 罗晔哲; 洪晓泉; 林恩德; 旷鹏昊; 陈清贵; 严威; 吴国洋**
厦门大学附属中山医院普通外科，厦门361004
Author(s):
Fu Jinbo;  Luo Yezhe;  Hong Xiaoquan;  et al.
Department of General Surgery, Xiamen Zhongshan Hospital of Xiamen University, Xiamen 361004, China
关键词:
甲状腺切除术; 腔镜; 腋窝径路; 胸乳径路
Keywords:
Thyroidectomy; Endoscopy; Axillary approach; Breast approach
文献标志码:
A
摘要:
目的比较经腋窝入路与经胸乳入路腔镜甲状腺切除术的临床应用价值。方法我院2013年1月~2016年1月手术治疗201例单侧甲状腺良性疾病，根据患者意愿，其中96例采用经腋窝入路，105例采用经胸乳入路，术中均不常规显露喉返神经。比较2组手术时间、出血量、引流量、住院时间、术后并发症。结果手术均获成功。与经胸乳组相比，经腋窝组手术时间短［（56.9±13.6）min vs. （71.4±11.3）min，t=-8.258，P=0.000］，术中出血少［（14.0±8.5） ml vs. （21.0±12.5）ml，t=-4.553，P=0.000］，术后引流少［（33.5±14.4）ml vs. （51.1±22.0）ml，t=-6.630，P=0.000］。2组住院时间差异无显著性［（5.3±0.9）d vs. （5.4±1.1）d，t=-0.475，P=0.635］。2组均无喉返神经损伤及甲状旁腺损伤等并发症。结论经腋窝及胸乳入路的腔镜甲状腺切除术是一种安全可行的方法，但经腋窝入路创伤程度及手术时间优于经胸乳入路。
Abstract:
ObjectiveTo compare the clinical value of axillary approach and breast approach for endoscopic thyroidectomy.MethodsFrom January 2013 to January 2016, 201 patients with unilateral thyroid benign disease were divided into two groups according to the patient’s wishes, either receiving endoscopic thyroidectomy through axillary approach (96 cases) or breast approach (105 cases). The recurrent laryngeal nerve did not routinely display in both procedures. The operative time, blood loss, drainage volume, hospital stay and postoperative complications were compared between the two groups. Results All the procedures were accomplished successfully. Compared with the breast group, the axillary group had shorter operation time ［(56.9±13.6) min vs. (71.4±11.3) min, t=-8.258, P=0.000］, less intraoperative blood loss ［(14.0±8.5) ml vs. (21.0±12.5) ml, t=-4.553, P=0.000)］, and less postoperative drainage ［(33.5±14.4) ml vs. (51.1±22.0) ml, t=-6.630, P=0.000］. There was no significant difference in hospitalization time between the two groups ［(5.3±0.9) d vs. (5.4±1.1) d, t=-0.475, P=0.635］. There were no severe complications such as injury of the recurrent laryngeal nerve or parathyroid gland in both groups. ConclusionBoth procedures for endoscopic thyroidectomy are safe and effective, and the axillary approach is superior to breast approach in surgical trauma and operation time.

参考文献/References:

[1]Wang YC,Zhu JQ,Liu K,et al.Surgical outcomes comparison between endoscopic and conventional open thyroidectomy for benign thyroid nodules.J Craniofac Surg,2015,26(8):e714-e718.
[2]姚宏伟，修典荣，王立新，等．完全腔镜、腔镜辅助以及常规开放甲状腺切除术的对比研究:前瞻性、非随机、对照研究.中国微创外科杂志,2010,10(5):415-419．
[3]罗轩明,曹新岭,兰志恒,等.胸乳入路腔镜与开放手术治疗甲状腺良性肿瘤的对比研究.中国微创外科杂志,2013,13(11):985-994.
[4]Al Kadah B,Piccoli M,Mullineris B,et al.Modifications of transaxillary approach in endoscopic da Vinciassisted thyroid and parathyroid gland surgery.J Robot Surg,2015,9(1):37-44.
[5]Yang J,Wang C,Li J,et al.Complete endoscopic thyroidectomy via oral vestibular approach versus areola approach for treatment of thyroid diseases.J Laparoendosc Adv Surg Tech A,2015,25(6):470-476.
[6]傅锦波，陈清贵，罗晔哲,等.经口入路腔镜下甲状腺切除手术五例经验.中华普通外科杂志,2012，27（4）：279-281.
[7]吴国洋,傅锦波,罗晔哲，等.经口入路腔镜甲状腺切除术37例.中华普通外科杂志，2014,29(1):32-35.
[8]Lee MC,Park H,Lee BC,et al.Comparison of quality of life between open and endoscopic thyroidectomy for papillary thyroid cancer.Head Neck,2016,38(Suppl 1):E827-E831.
[9]Li Y,Zhou X.Comparison between endoscopic thyroidectomy and conventional open thyroidectomy for papillary thyroid microcarcinoma:a metaanalysis.J Cancer Res Ther,2016,12(2):550-555.
[10]Park KN,Jung CH,Mok JO,et al.Prospective comparative study of endoscopic via unilateral axillobreast approach versus open conventional total thyroidectomy in patients with papillary thyroid carcinoma.Surg Endosc,2016,30(9):3797-801.

备注/Memo

备注/Memo:
基金项目：厦门大学消化中心基金项目（201207）**通讯作者，Email:wuguoyangmail@aliyun.com
更新日期/Last Update: 2017-11-22