示踪用盐酸米托蒽醌注射液在经胸前入路腔镜甲状腺癌手术中的应用价值
The value of mitoxantrone hydrochloride injection for tracing in endoscopic thyroidectomy via anterior chest approach for the treatment of papillary thyroid carcinoma
宁小晶 1汪洪宇 2傅丽元 1殷毅 1花苏榕2
作者信息
- 1. 北京市隆福医院普外科,北京 100010
- 2. 中国医学科学院北京协和医院基本外科,北京 100730
- 折叠
摘要
目的 探讨示踪用盐酸米托蒽醌注射液在经胸前入路腔镜甲状腺癌手术中的应用价值.方法 回顾性研究北京市隆福医院普通外科(北京协和医院医联体单位)自2022年9月至2024年3月收治的接受经胸前入路腔镜甲状腺癌手术的患者,分为未使用示踪剂组(对照组)和使用示踪用米托蒽醌组(示踪剂组),手术均由同一手术组医生完成.比较两组的基线及术后病理和并发症情况.结果 最终有25例(13例对照组,12例示踪剂组)纳入本研究.示踪剂组和对照组分别平均清扫中央区淋巴结为(7.4±4.6)枚/每侧和(2.4±1.9)枚/每侧,示踪剂组显著多于对照组(P=0.004).两组术后病理中均未见误切的甲状旁腺,未发生喉返神经损伤.两组在一过性低钙血症发生率方面差异无统计学意义(P=0.503),但在一过性甲状旁腺激素减低发生率方面示踪剂组为1例(1/12,8.3％),优于对照组的4例(4/13,30.8％)(P=0.009),甲状旁腺激素下降幅度示踪剂组为(5.4±8.1)μg/mL,优于对照组的(20.0±11.1)μg/mL(P=0.001).在术后总引流液量方面,示踪剂组为(142.9±71.7)mL,多于对照组的(87.7±38.8)mL(P=0.030),但并不影响两组的拔管时间(P=0.610).示踪剂组在术后2周观察时无皮肤穿刺点示踪剂残留.结论 示踪用米托蒽醌在经胸前入路腔镜甲状腺癌手术中的应用安全可靠,能显著提高中央区淋巴结的病理数目,同时能提高甲状旁腺的辨识率,对其起到更好的保护作用,且在术后2周无皮肤穿刺点的染色剂残留,不影响美观.
Abstract
Objective To explore the value of mitoxantrone hydrochloride injection for tracing in endo-scopic thyroidectomy(ETE)via anterior chest approach for papillary thyroid carcinoma(PTC).Methods A retro-spective analysis was conducted on patients undergoing ETE via anterior chest approach for PTC admitted to Bei-jing Longfu Hospital(Medical Treatment Combination with Peking Union Medical College Hospital)from Sep.2022 to Mar.2024.The patients were divided into two groups:the control group(without tracer)and the tracer group(with mitoxantrone hydrochloride injection for tracing).All surgeries were performed by the same thyroid surgical team.Baseline,postoperative pathologies and complications were compared between the 2 groups.Results A total of 25 patients(13 in the control group and 12 in the tracer group)were included in this study,and the aver-age dissection of unilateral central region lymph nodes in the tracer group was 7.4±4.6,significantly more than in the control group(2.4±1.9)(P=0.004).There were no instances of mistakenly resected parathyroid gland in the postoperative pathology or accidental in-jury of recurrent laryngeal nerve in either group.The incidence of transient hypocalcemia did not significantly different between the two groups(P=0.503).However,the incidence of transient hypoparathyroidism in the tracer group was 1(1/12,8.3％),significantly lower than in the control group 4(4/13,30.8％)(P=0.009).The tracer group exhibited more impressive levels in parathyroid hormone(5.4±8.1)μg/mL compared to the control group(20.0±1 1.1)μg/mL(P=0.001).The total volume of postoperative drainage in the tracer group(142.9±71.7)mL was more than that of the control group(87.7±38.8)mL(P=0.030).But It did not affect the extubation time in either group(P=0.610).No residual tracer was observed at the skin puncture site in the tracer group after 2 weeks.Conclusions Mitoxan-trone hydrochloride injection for tracing as tracer in ETE via breast approach can increase the number of pathological lymph nodes dis-section in cervical central region.Combined with negative development,identifying and protecting the function of parathyroid glands show feasible and potential application value to improve the safety of thyroidectomy.The use of mitoxantrone hydrochloride injection for tracer has the risk of increased exudation from the surgical area,but does not affect the time to remove the drain.
关键词
甲状腺乳头状癌/腔镜甲状腺切除术/示踪用盐酸米托蒽醌注射液/中央区淋巴结清扫/甲状旁腺Key words
Papillary thyroid carcinoma/Laparoscopic thyroidectomy/Mitoxantrone hydrochloride injection for tracing/Central lymph node dissection/Parathyroid引用本文复制引用
基金项目
中央高水平医院临床科研业务费(2022-PUMCH-B-003)
出版年
2024
NETL
NSTL
万方数据