[1]刘岩 田志龙 高新宝 袁福康 耿厚法 贾高磊**.无充气经腋窝后入路腔镜甲状腺微灶癌手术47例[J].中国微创外科杂志,2022,01(10):803-807.
 Liu Yan,Tian Zhilong,Gao Xinbao,et al.Endoscopic Thyroidectomy Through Gasless Axillary Posterior Approach for Thyroid Microcarcinoma[J].Chinese Journal of Minimally Invasive Surgery,2022,01(10):803-807.
点击复制

无充气经腋窝后入路腔镜甲状腺微灶癌手术47例()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年10期
页码:
803-807
栏目:
临床研究
出版日期:
2023-01-20

文章信息/Info

Title:
Endoscopic Thyroidectomy Through Gasless Axillary Posterior Approach for Thyroid Microcarcinoma
作者:
刘岩 田志龙 高新宝 袁福康 耿厚法 贾高磊**
(徐州市中心医院血甲疝微创外科,徐州221006)
Author(s):
Liu Yan Tian Zhilong Gao Xinbao et al.
Department of Vascular Thyroid Hernia Surgery, Xuzhou Central Hospital, Xuzhou 221006, China
关键词:
腔镜腋窝后入路甲状腺微灶癌淋巴结清扫
Keywords:
LaparoscopyAxillary posterior approachThyroid microcarcinomaLymph node dissection
文献标志码:
A
摘要:
目的探讨无充气经腋窝后入路腔镜甲状腺微灶癌手术的安全性。方法2020年1月~2022年2月我院对47例甲状腺微灶癌行无充气经腋窝后入路腔镜甲状腺单侧腺叶和峡部切除联合中央区淋巴结清扫术。结果47例手术均顺利完成,无中转开放手术。手术时间65~145 min,(101.5±20.3)min。术中出血量5~40 ml,中位数15 ml。住院时间3~9 d,(6.0±1.4)d。术后病理:微灶乳头状癌;淋巴结清扫2~11枚,(4.7±1.9)枚。术后无严重并发生发生。术后美容满意程度评分表(9.2±0.7)分,满意度较高。47例术后随访2~26个月,平均12.2月,均未见肿瘤复发及颈部淋巴结转移。结论无充气经腋窝后入路腔镜甲状腺微灶癌手术安全可行,能很好地全程暴露喉返神经及保护甲状旁腺,美容满意度高。
Abstract:
ObjectiveTo explore the safety of endoscopic thyroidectomy through gasless axillary posterior approach for thyroid microcarcinoma.MethodsClinical data of 47 patients with thyroid microcarcinoma undergoing endoscopic unilateral thyroid lobectomy with isthmus resection and central lymph node dissection through gasless unilateral axillary posterior approach from January 2020 to February 2022 were retrospectively analyzed.ResultsAll the operations were successfully completed without conversion to open surgery. The operation time was 65-145 min, with an average of (101.5±20.3) min. The intraoperative blood loss was 5-40 ml, with an median of 15 ml. The total hospital stay was 3-9 d, with an average of (6.0±1.4) d. Postoperative pathology confirmed the diagnosis of papillary carcinoma. The number of lymph nodes dissected was 2-11, with an average of 4.7±1.9. There was no serious complication after operation. The average score on cosmetic satisfaction scale was (9.2±0.7) points, indicating high satisfaction. There was no tumor recurrence or cervical lymph node metastasis in the 47 cases during followups for 2-26 months (mean, 12.2 months).ConclusionsEndoscopic thyroidectomy for papillary thyroid microcarcinoma through gasless axillary posterior approach is safe and feasible. It can well expose the recurrent laryngeal nerve and parathyroid gland, and has a good cosmetic effect.

参考文献/References:

[1]赫捷,李进,程颖,等.中国临床肿瘤学会(CSCO)分化型甲状腺癌诊疗指南2021.肿瘤预防与治疗,2021,34(12):1164-1201.
[2]王小飞,刘枫, 郑洵,等.无充气腋窝入路腔镜甲状腺微小乳头状癌手术的学习曲线.中国普外基础与临床杂志,2021,28(10):1270-1274.
[3]郑传铭,徐加杰,蒋烈浩,等.无充气腋窝入路完全腔镜下甲状腺叶切除的方法——葛-郑氏七步法.中国普通外科杂志,2019,28(11):1336-1341.
[4]Lei S, Ding Z, Ge J, et al. Anatomy of mesothyroid: value of mesothyroid excision in thyroid cancer patients. Hepatogastroenterology,2014, 61(136):2181-2184.
[5]Roh MR. The SCAR(Scar Cosmesis Assessment and Rating) scale: new evaluation method for postoperative scars. Br J Dermatol,2016,175(6):1151-1152.
[6]汪杰,李良.腔镜甲状腺手术的临床应用进展.腹腔镜外科杂志,2021,26(9):711-714.
[7]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.中国微创外科杂志,2017,17(8):688-690.
[8]于晓天,沈振伟,唐晓燕,等.经胸乳入路腔镜甲状腺手术、低位小切口手术与传统甲状腺切除手术的临床疗效观察.中华普外科手术学杂志(电子版), 2021,15(5):574-577.
[9]易亮,柳泽洋,彭小伟,等.经口腔前庭入路腔镜甲状腺手术适应证及禁忌证.中华耳鼻咽喉头颈外科杂志,2020,55(10):975-979.
[10]Qu R, Li J, Yang J, et al. Treatment of differentiated thyroid cancer: can endoscopic thyroidectomy via a chestbreast approach achieve similar therapeutic effects as open surgery? Surg Endosc,2018,32(12):4749-4756.
[11]徐加杰,张李卓,张启弘,等.无充气经腋窝腔镜甲状腺手术的临床应用.中华耳鼻咽喉头颈外科杂志,2020,55(10):913-920.
[12]贾高磊,田志龙,耿厚法,等.无充气腋窝入路完全腔镜下甲状腺手术意外出血的处理.中国微创外科杂志,2022,22(7):570-574.
[13]中国抗癌协会甲状腺癌专业委员会,中华医学会肿瘤学分会甲状腺肿瘤专业委员会,中国研究型医院学会甲状腺疾病专业委员会,等.无充气腋窝入路腔镜甲状腺手术专家共识(2022版).中华内分泌外科杂志,2021,15(6):557-563.

备注/Memo

备注/Memo:
基金项目:江苏省科教强卫青年医学人才重点项目(QNRC2016388)**通讯作者,Email:jiagaolei@163.com
更新日期/Last Update: 2023-01-20