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目的:比较全乳晕入路和经胸乳入路腔镜甲状腺微灶癌手术的临床效果。方法:回顾性分析2014年1月—2015年6月甲状腺微灶癌患者行腔镜下甲状腺腺叶+峡部切除与中央组淋巴结清扫术50例,其中行全乳晕入路21例(全乳晕组),胸乳区入路29例(胸乳组),比较两组患者的相关临床指标。结果:两组患者年龄、肿瘤最大直径差异无统计学意义(均P>0.05)。两组患者均在腔镜下顺利完成手术,全乳晕组与胸乳组比较,平均淋巴结清扫数目(5.90枚vs.6.07枚)、手术时间(99.95 min vs.99.17 min)、术中出血量(23.81 m L vs.28.21 m L)、住院时间(5.19 d vs.6.07 d)、术后疼痛评分及术后并发症发生率差异均无统计学意义(均P>0.05);全乳晕组患者对手术切口满意度明显高于胸乳组(8.81vs.6.59,P<0.0001)。结论:全乳晕入路腔镜甲状腺手术与胸乳入路腔镜甲状腺手术在治疗甲状腺微灶癌方面疗效相当,全乳晕入路具有更好的美容效果,是一种安全理想的手术方式。
Objective: To compare the clinical effects of total areola approach and endoscopic thyroidectomy for malignant thyroid carcinoma. Methods: From January 2014 to June 2015, 50 patients with thyroid glandular carcinoma underwent endoscopic gonadotomy and isthmus resection and central lymph node dissection were retrospectively analyzed. Twenty-one patients underwent total areola approach (total areola group) , Breast area approach 29 cases (breast milk group), comparing the two groups of patients related clinical indicators. Results: There was no significant difference in age and tumor diameter between the two groups (all P> 0.05). The patients underwent endoscopic surgery underwent endoscopic surgery successfully. The average number of lymph node dissection (5.90 vs. 6.07) in the total areola group was significantly lower than that in the breast tube group (99.95 min vs.99.17 min) 23.81 m L vs.28.21 m L), hospital stay (5.19 d vs 6.07 d), postoperative pain score and incidence of postoperative complications were not statistically significant (all P> 0.05) Surgical incision satisfaction was significantly higher than the breast milk group (8.81 vs 6.59, P <0.0001). Conclusion: The treatment of total areola approach endoscopic thyroidectomy and endoscopic thyroidectomy in the treatment of thyroid cancer is equivalent to the efficacy of the whole breast approach has a better cosmetic effect, is a safe and ideal surgical approach.