目的:本前瞻性研究旨在探讨内镜下甲状腺切除术与常规甲状腺切除术的临床疗效及炎症反应。
方法:我们前瞻性招募了2021年1月至2022年7月在上海交通大学医学院附属上海第六人民医院接受常规开放甲状腺切除术或内镜下甲状腺切除术的45例患者(共90例)。使用以下指标对这些患者进行评估:解剖的淋巴结数量,并发症,疼痛严重程度,炎症指标,化妆品满意度,和经济成本。所有数据采用t检验或卡方检验进行分析。
结果:纳入90例患者。两组在基线特征方面没有显着差异。所有接受甲状腺切除术的患者的创伤指数相似,炎症水平升高。开腹甲状腺切除术组和腔镜下甲状腺切除术组的淋巴结清扫总数差异无统计学意义,阳性淋巴结数,排水量,和并发症。在温哥华瘢痕评分和美容满意度评分方面,髁下内镜甲状腺切除术组明显优于开放甲状腺切除术组。在术后第1天和第2天,下网膜内镜甲状腺切除术组的疼痛评分明显降低,停机时间更短,与开放式甲状腺切除术组相比,医疗和美容费用更便宜。
结论:与传统的开放性甲状腺切除术相比,下内镜甲状腺切除术并没有增加创伤的程度,具有优越的临床疗效,减少疼痛,需要更短的停机时间,达到了更好的美容效果,并与较低的医疗保健成本有关。
This prospective study aimed to explore the clinical efficacy and inflammatory reaction of
submental endoscopic thyroidectomy versus conventional thyroidectomy.
We prospectively recruited 45 patients (total 90 patients) who met the eligibility criteria to undergo conventional open thyroidectomy or
submental endoscopic thyroidectomy from January 2021 to July 2022 in the Shanghai Sixth People\'s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. These patients were evaluated using the following indices: number of lymph nodes dissected, complications, pain severity, inflammatory indicators, cosmetic satisfaction, and economic cost. All data were analyzed by the t-test or chi-squared test.
Ninety patients were enrolled. The two groups did not significantly differ regarding baseline characteristics. All patients who underwent thyroidectomy had a similar trauma index and increased level of inflammation. There were no significant differences between the open thyroidectomy and
submental endoscopic thyroidectomy groups in the total number of lymph nodes dissected, number of positive lymph nodes, drainage volume, and complications. The Vancouver scar score and cosmetic satisfaction score were significantly better in the submental endoscopic thyroidectomy group than the open thyroidectomy group. The
submental endoscopic thyroidectomy group had a significantly lower pain scores on postoperative days 1 and 2, less downtime, and cheaper medical and esthetic costs than the open thyroidectomy group.
Compared with conventional open thyroidectomy,
submental endoscopic thyroidectomy did not increase the degree of trauma, had superior clinical efficacy, caused less pain, required a shorter downtime, achieved a better cosmetic effect, and was associated with lower healthcare costs.