首页|腔镜下甲状腺癌颈侧区淋巴结清扫术后并发淋巴漏防治研究

腔镜下甲状腺癌颈侧区淋巴结清扫术后并发淋巴漏防治研究

Experience in the prevention and treatment of lymphatic leakage after scarless endoscopic thyroidectomy-lateral neck dissection in thyroid cancer

扫码查看
目的 对比分析甲状腺乳头状癌(papillary thyroid cancer,PTC)行腔镜下颈侧区淋巴结清扫(scarless endoscopic thyroidectomy-lateral neck dissection,SET-LND)与开放式颈侧区淋巴结清扫(lateral neck dissection,LND)的手术结果,并探讨LND术后并发淋巴漏防治方法.方法 回顾性分析2021年1月至2022年8月浙江大学医学院附属第二医院行LND手术的PTC患者共90例,男25例,女65例,年龄(28.06±4.89)岁.分为SET-LND组(50例)和开放式LND组(40例),观察两组术中失血、手术时长、术后住院时间、第一天、第二天引流量、术后有无淋巴漏、术后肿瘤病理大小、肿瘤最大径(tumor,T),术后病理提示淋巴结转移数量(node,N).分类变量资料组间比较行x2检验,各项符合正态分布的连续变量资料组间比较,采用独立样本t检验.结果 SET-LND组手术时长为(284.00±74.65)min,显著高于开放式LND组的(145.38±43.26)min(t=-10.42,P<0.001);比较两组术中失血[(21.22±18.13)mL vs.(17.10±9.14)mL(t=-1.31,P=0.194)]、术后住院时间[(3.44±1.20)d vs.(3.40±1.60)d(t=-0.14,P=0.892)]、术后第一天引流量[(152.88±45.18)mLvs.(138.85± 64.51)mL(t=-1.07,P=0.286)]、第二天引流量[(101.16±45.44)mL vs.(85.83±64.51)mL(t=-1.60,P=0.114)]、术后有无淋巴漏[(45/5 vs.36/4)(x2=0.00,P=0.989)]、T[(1.28±0.72)vs.(1.34±0.75)(t=0.37,P=0.714)]、N[(8.32± 6.94)vs.(6.30±4.24)(t=-1.61,P=0.110)],差异均无统计学意义.结论 两种手术方式行LND的治疗效果相似,SET-LND组淋巴漏发生率与开放组差异无统计学意义.
Objective To compare the surgical outcomes between scarless endoscopic thyroidectomy-lat-eral neck dissection(SET-LND)and open LND for papillary thyroid cancer(PTC)with lymph node metastasis and to share the experience in the prevention and treatment of lymphatic leakage after LND.Methods Totally 90 PTC patients(25 males)who underwent LND in the Second Affiliated Hospital of Zhejiang University School of Medicine from Jan.2021 to Aug.2022 were retrospectively enrolled,with an average age of(28.06±4.89)years.They were divided into the SET-LND group(n=50)and the open LND group(n=40).The intraoperative blood loss,operation time,drainage volume on the first and the second days,postoperative lymphatic leakage,tumor(T),and node(N)were observed.The categorical variable data were compared between groups by x2 test,and the con-tinuous variable data confirming normal distribution were compared between groups by independent sample t-test.Results The operation time of the SET-LND group was(284.00±74.65)min,significantly longer than that of the open LND group(145.38±43.26)min(t=-10.42,P<0.001).The intraoperative blood loss(t=-1.309,P=0.194),postoperative hospital stay(t=-0.136,P=0.892),drainage volume on the first day(t=-1.074,P=0.286),and drain-age volume on the second day(t=-1.595,P=0.114),postoperative lymphatic leakage(x2=0.001,P=0.989),T(t=0.367,P=0.714),N(t=-1.614,P=0.110)were not significantly different between the two groups.Conclusion Two surgical methods of LND have similar therapeutic effects and no significant difference was observed in the inci-dence of postoperative lymphatic leakage between the two groups.

Papillary thyroid cancerScarless endoscopic thyroidectomy-lateral neck dissectionOpen lateral neck dissectionlymphatic leakage

占三辉、马军杰、项承、王平

展开 >

盐城市亭湖区人民医院普外科,盐城 224000

浙江大学医学院附属第二医院甲状腺外科,杭州 310003

甲状腺乳头状癌 腔镜下颈侧区淋巴结清扫术 开放式颈侧区淋巴结清扫术 淋巴漏

浙江省基础公益研究计划

LGF19H160028

2024

中华内分泌外科杂志
中华医学会

中华内分泌外科杂志

CSTPCD
影响因子:0.657
ISSN:1674-6090
年,卷(期):2024.18(1)
  • 10