[1]高文彩,王 玲,吴慧敏,等.经口腔前庭入路腔镜甲状腺切除术在甲状腺乳头状癌治疗中的应用价值研究[J].陕西医学杂志,2024,(3):344-347.[doi:DOI:10.3969/j.issn.1000-7377.2024.03.012]
　GAO Wencai,WANG Ling,WU Huimin,et al.Application value of transoral endoscopic thyroidectomy vestibular approach in treatment of papillary thyroid carcinoma[J].,2024,(3):344-347.[doi:DOI:10.3969/j.issn.1000-7377.2024.03.012]
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经口腔前庭入路腔镜甲状腺切除术在甲状腺乳头状癌治疗中的应用价值研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年3期
页码:
344-347
栏目:
临床研究
出版日期:
2024-03-05

文章信息/Info

Title:
Application value of transoral endoscopic thyroidectomy vestibular approach in treatment of papillary thyroid carcinoma
作者:
高文彩; 王 玲; 吴慧敏; 程祥英; 李发毅
(成都医学院第二附属医院 核工业四一六医院手术室,四川 成都 610057)
Author(s):
GAO Wencai; WANG Ling; WU Huimin; CHENG Xiangying; LI Fayi
(Operating Room,the 2nd Affiliated Hospital of Chengdu Medical College,Chengdu 610057,China)
关键词:
甲状腺乳头状癌;  经口腔前庭入路腔镜甲状腺切除术;  甲状腺开放手术;  治疗效果;  应用价值;  美观满意度
Keywords:
Papillary thyroid carcinoma;  Transoral endoscopic thyroidectomy vestibular approach;  Open thyroid surgery;  Therapeutic effect;  Application value;  Aesthetic satisfaction
分类号:
R 736.1
DOI:
DOI:10.3969/j.issn.1000-7377.2024.03.012
文献标志码:
A
摘要:
目的:探讨经口腔前庭入路腔镜甲状腺切除术(TOETVA)在甲状腺乳头状癌(PTC)治疗中的应用价值。方法:选取PTC患者82例,按照手术方式不同分为TOETVA组(37例)和开放组(45例)。比较两组患者围手术期指标和临床病理学指标。比较两组患者术前及术后6个月甲状腺功能[血钙、甲状旁腺素(PTH)和甲状腺球蛋白抗体(TgAb)]。比较两组患者术后6个月对切口瘢痕美观满意度[温哥华瘢痕评估量表(VSS)和患者瘢痕评价量表(PSAS)] 以及术后并发症发生情况。结果:与开放组比较,TOETVA组患者手术时间增加,术后24 h颈部VAS评分降低,住院时间缩短(均P<0.05)。两组患者单/双侧甲状腺清扫、阳性淋巴结数目和淋巴结转移阳性率比较差异无统计学意义(均P>0.05)。与同组术前比较,,两组术后6个月血钙、PTH和TgAb水平降低(均P<0.05); 血钙、PTH和TgAb水平两组间比较差异无统计学意义(均P>0.05)。TOETVA组患者VAA和PSAS评分低于开放组(均P<0.05)。术后6个月内,两组患者并发症总发生率比较差异无统计学意义(P>0.05)。结论:TOETVA在治疗PTC时与传统开放手术具有同样的有效性及安全性,但在瘢痕美观方面具有明显优势。
Abstract:
Objective:To explore the Application value of transoral endoscopic thyroidectomy vestibular approach(TOETVA)in treatment of papillary thyroid carcinoma(PTC).Methods:A total of 82 patients with PTC were selected.They were divided into TOETVA group(37 cases)and open group(45 cases)according to different surgical methods.The perioperative and clinicopathological indexes were compared between the two groups.Thyroid function(blood calcium,parathyroid hormone [PTH] and thyroglobulin antibody [TgAb])were compared between the two groups before and 6 months after surgery.The aesthetic satisfaction of postoperative incision scars(Vancouver Scar Scale [VSS] and Patient Scar Assessment Scale [PSAS])and the incidence of postoperative complications were compared between the two groups 6 months after surgery.Results:Compared with the open group,the operation time of TOETVA group was increased,the 24-hour postoperative neck visual analog scale(VAS)score was decreased,and the length of hospital stay was shortened(all P<0.05).There was no significant difference in the unilateral and bilateral thyroid dissection,the number of positive lymph nodes and positive rate of lymph node metastasis between the two groups(all P>0.05).At 6 months after surgery,the levels of blood calcium,PTH and TgAb were decreased compared with those in the same group before surgery(all P<0.05),but there were no significant differences in serum calcium,PTH and TgAb levels between the two groups(all P>0.05).The scores of VAA and PSAS in TOETVA group were lower than those in open group(all P<0.05).Within 6 months after surgery,there was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion:TOETVA has the same efficacy and safety as traditional open surgery in the treatment of PTC,but it has obvious advantages in scar aesthetics.

参考文献/References:

[1] 吴海滨,赵爱国,苗雅云,等.甲状腺乳头状癌组织中肿瘤转移相关基因1、叉头翼螺旋转录因子3水平变化与临床病理特征及淋巴转移的关系[J].陕西医学杂志,2023,52(5):613-617.
[2] 王毅.经胸骨切迹入路腔镜甲状腺手术对比传统开放手术治疗甲状腺乳头状癌疗效分析[J].川北医学院学报,2021,36(11):1432-1435.
[3] GUO F,WANG W,ZHU X,et al.Comparative study between endoscopic thyroid surgery via the oral vestibular approach and the areola approach[J].J Laparoendosc Adv Surg Tech A,2020,30(2):170-174.
[4] 张世伟,赵海平,骆焕平,等.经口腔前庭入路腔镜与传统开放甲状腺手术的临床对照研究[J].腹腔镜外科杂志,2022,27(5):328-331.
[5] 中国抗癌协会甲状腺癌专业委员会.中国抗癌协会甲状腺癌整合诊治指南(2022精简版)[J].中国肿瘤临床,2023,50(7):325-330.
[6] SUNG Y T,WU J S.The visual analogue scale for rating,ranking and paired-comparison(VAS-RRP):A new technique for psychological measurement[J].Behav Res Methods,2018,50(4):1694-1715.
[7] SEO S R,KANG N O,YOON M S,et al.Measurements of scar properties by SkinFibroMeter,SkinGlossMeter,and Mexameter and comparison with vancouver scar scale[J].Skin Res Technol,2017,23(3):295-302.
[8] LENZI L,SANTOS J,RADUAN NETO J,et al.The patient and observer scar assessment scale:Translation for portuguese language,cultural adaptation,and validation[J].Int Wound J,2019,16(6):1513-1520.
[9] 来益,沈宇玲,王家东.不同入路腔镜甲状腺手术和传统开放甲状腺手术疗效分析[J].中国眼耳鼻喉科杂志,2023,23(1):34-38.
[10] BENHIDJEB T,STARK M,SCHULTE A E J.Re:“Comparative study between endoscopic thyroid surgery via the oral vestibular approach and the areola approach” by GUO et al[J].J Laparoendosc Adv Surg Tech A,2020,30(8):866-867.
[11] 徐伟宏,梅锋,李强.经口腔前庭腹腔镜甲状腺切除术联合131Ⅰ治疗分化型甲状腺癌的效果及近中期预后分析[J].中国医学物理学杂志,2022,39(12):1563-1568.
[12] ZHOU X,DENG J,XIONG J,et al.Factors influencing the acceptance of endoscopic thyroidectomy via oral vestibular approach(ETOVA)by thyroid surgery candidates[J].Surg Laparosc Endosc Percutan Tech,2022,32(5):554-557.
[13] 龚根强,曹亮,帖小妮.腔镜甲状腺手术治疗良性甲状腺疾病疗效观察[J].陕西医学杂志,2015,44(12):1652-1653.
[14] 童真,张世达.无充气经腋窝入路腔镜手术治疗早期甲状腺肿瘤疗效及对患者免疫功能和美学效果的影响[J].陕西医学杂志,2020,49(11):1422-1425.
[15] 刘宁,杜茂芳,任忠峰.经口腔前庭入路腔镜手术治疗甲状腺癌的临床研究[J].中国现代普通外科进展,2022,25(4):318-319.
[16] SHI Y,ZHANG L,LIU C,et al.Comparison of surgical outcomes between patients undergoing trans-oral endoscopic thyroid surgery combined with trans-thoracoareolar approach and conventional open surgery[J].Front Surg,2022,9:916874.
[17] 易茂林,黄能为,张志文,等.经口前庭入路在腔镜微创甲状腺癌手术中的应用价值[J].疑难病杂志,2022,21(9):949-953.
[18] ZHANG D,CARUSO E,SUN H,et al.Classifying pain in transoral endoscopic thyroidectomy[J].J Endocrinol Invest,2019,42(11):1345-1351.
[19] 陈懿,张姝,张刚,等.50例经口腔前庭入路腔镜甲状腺手术临床应用体会[J].肿瘤预防与治疗,2019,32(5):441-446.
[20] 张海超,陈隽,周秦毅,等.经口腔前庭腔镜手术与颈部开放手术治疗甲状腺乳头状癌的临床研究[J].中国耳鼻咽喉头颈外科,2021,28(8):514-516.
[21] AKRITIDOU E,DOURIDAS G,SPARTALIS E,et al.Complications of trans-oral endoscopic thyroidectomy vestibular approach:A systematic review[J].In Vivo,2022,36(1):1-12.
[22] 罗夏敏,唐冠兰,滕晓洁,等.含碘中药治疗甲状腺疾病研究进展[J].陕西中医,2022,43(5):677-680.
[23] SHEN S,HU X,QU R,et al.Comparing quality of life between patients undergoing trans-areola endoscopic thyroid surgery and trans-oral endoscopic thyroid surgery[J].BMC Surg,2021,21(1):277.
[24] 李武,伍鹏,李赞,等.经口腔前庭入路腔镜甲状腺手术并发症预防及处理:单中心1941例及文献报道152例多中心数据分析[J].中国普通外科杂志,2022,31(11):1422-1429.
[25] 廖雪英,齐磊,曾兴玲,等.经口腔前庭入路行腔镜下甲状腺癌根治术效果探讨[J].中国美容医学,2021,30(10):41-44.
[26] 乔雷,贾文磊,董朝,等.经口腔前庭入路甲状腺癌根治术与开放手术比较[J].中华保健医学杂志,2021,23(5):516-517.

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备注/Memo

备注/Memo:
基金项目:成都市医学科研课题(2021150)
更新日期/Last Update: 2024-03-05