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目的探讨腔镜辅助小切口甲状腺手术在cN0期甲状腺乳头状癌手术治疗中的可行性。方法 2009年1月至2010年10月期间,采用腔镜辅助小切口甲状腺手术方法对11例cN0期甲状腺乳头状癌进行手术,与同期进行的12例开放性手术作对比分析。结果腔镜辅助组手术时间较传统手术组长(P<0.05),但没有延长住院时间(P>0.05),清扫淋巴结数目也未受影响(P>0.05),手术后引流量较传统手术组少(P<0.01)。术后腔镜辅助组1例患者出现迟发性暂时性声音嘶哑,其余均未出现出血、声嘶、呛咳和手足抽搐等并发症。术后3个月随访结果显示,腔镜辅助组对切口满意度评分较高(P<0.01)。术后中位随访12(3~22)个月,甲状腺超声检查均未发现复发、转移征象。结论早期甲状腺乳头状癌可以考虑施行腔镜辅助小切口手术,初步应用结果表明该术式具有较好的安全性和可行性。
Objective To investigate the feasibility of endoscopic small-incision thyroidectomy in the treatment of cN0 thyroid papillary carcinoma. Methods From January 2009 to October 2010, 11 cases of cN0 papillary thyroid carcinoma were treated by endoscopic small-incision thyroidectomy and compared with 12 cases of open surgery during the same period. Results The operation time of endoscopic assisted group was longer than that of traditional operation group (P <0.05), but did not prolong the length of hospital stay (P> 0.05). The number of lymph nodes was also not affected (P> 0.05) Less (P <0.01). Postoperative laparoscopic assisted group 1 patients with delayed temporary hoarseness of the sound, the rest were no bleeding, hoarseness, cough and hand-foot convulsions and other complications. The follow-up results at 3 months after operation showed that the endoscopic satisfaction group had a higher score of incision satisfaction (P <0.01). Postoperative median follow-up 12 (3 ~ 22) months, thyroid ultrasound examination showed no signs of recurrence and metastasis. Conclusion Early thyroid papillary carcinoma can be considered for the implementation of endoscopic small incision assisted surgery, preliminary results show that the surgery has good safety and feasibility.