Abstract:

Objective　To explore the effects of endoscopic thyroidectomy via the oral vestibular approach versus via the areola approach in the treatment of patients with thyroid nodules. Methods　A total of 86 patients with thyroid nodules admitted to Dezhou Municipal Hospital from March 2021 to March 2022 were selected for the randomized controlled trial. They were divided into a conventional group and a study group by the random number table method, with 43 cases in each group. There were 22 males and 21 females in the conventional group; they were 48-82 (59.85±10.25) years old. There were 20 males and 23 females in the study group; they were 47-81 (59.52±10.01) years. The conventional group underwent endoscopic thyroidectomy via the areola approach, while the study group underwent endoscopic thyroidectomy via the oral vestibular approach. The surgery-related indicators (intraoperative bleeding volume and operation time), scores of Standardized Swallowing Assessment (SSA), and incidences of complications within 1 month after the surgery were compared between the two groups. t and χ² tests were applied. Results　The operation time and intraoperative bleeding volume in the study group were less than those in the conventional group [(52.14±10.02) min vs. (56.87±10.14) min and (12.14±2.85) ml vs. (15.74±3.01) ml], with statistical differences (t=2.176 and 5.695; P=0.032 and <0.001). Before the surgery, there was no statistical difference in the score of SSA between the two groups (P>0.05). After the surgery, the scores of SSA in both groups were lower than those before the surgery; the score in the study group was lower than that in the conventional group [(18.12±1.11) vs. (21.58±1.25)]; there were statistical differences (all P<0.05). The incidence of complications within 1 month after the surgery in the study group was lower than that in the conventional group [4.65% (2/43) vs. 18.60% (8/43); P<0.05]. Conclusion　Compared with endoscopic thyroidectomy through the areolar approach, endoscopic thyroidectomy through the oral vestibular approach is more effective for patients with thyroid nodules, and can reduce surgical trauma, improve their swallowing function, and reduce the incidence of complications.

Key words:

Thyroid nodules, Oral vestibular approach, Areolar approach, Endoscopic thyroidectomy

摘要：

目的　探讨经口腔前庭入路与经乳晕入路腔镜甲状腺切除术治疗甲状腺结节患者的效果。方法　选取2021年3月至2022年3月德州市立医院收治的86例甲状腺结节患者进行随机对照试验，以随机数字表法将其分成常规组与研究组，各43例。常规组男22例，女21例，年龄48～82（59.85±10.25）岁；研究组组男20例，女23例，年龄47～81（59.52±10.01）岁。常规组采用经乳晕入路腔镜甲状腺切除术治疗，研究组采用经口腔前庭入路腔镜甲状腺切除术治疗。比较两组手术相关指标（术中出血量、手术时间）、吞咽功能量表（Standardized Swallowing Assessment，SSA）评分及术后1个月内并发症发生情况。采用t检验和χ²检验。结果　研究组手术时间短于常规组［（52.14±10.02）min比（56.87±10.14）min］，术中出血量低于常规组［（12.14±2.85）ml比（15.74±3.01）ml］，差异均有统计学意义（t=2.176、5.695，P=0.032、<0.001）。术前，两组SSA评分差异无统计学意义（P>0.05）；术后，两组SSA评分均低于术前，且研究组SSA评分低于常规组［（18.12±1.11）分比（21.58±1.25）分］，差异均有统计学意义（均P<0.05）。研究组术后1个月内并发症总发生率低于常规组［4.65%（2/43）比18.60%（8/43），P<0.05］。结论　相比于经乳晕入路腔镜甲状腺切除术，经口腔前庭入路腔镜甲状腺切除术治疗甲状腺结节患者效果更佳，可减轻手术创伤、改善患者的吞咽功能、降低并发症总发生率。

关键词:

甲状腺结节, 口腔前庭入路, 乳晕入路, 腔镜甲状腺切除术