中国实用外科杂志

中国实用外科杂志 ›› 2022, Vol. 42 ›› Issue (06): 700-703.DOI: 10.19538/j.cjps.issn1005-2208.2022.06.21

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日间经口腔前庭入路腔镜甲状腺癌根治术可行性及安全性研究

陈    航，罗宇庭，龚智娴，朱小萍   

  1. 南昌大学第一附属医院日间病房，江西南昌330006
  • 出版日期:2022-06-01 发布日期:2022-06-12

  • Online:2022-06-01 Published:2022-06-12

摘要： 目的    分析在日间病房围手术期模式下经口腔前庭入路腔镜甲状腺癌根治术的可行性、安全性及优势。方法    回顾性分析2019年1月至2021年4月南昌大学第一附属医院行经口腔前庭入路腔镜单侧甲状腺癌根治术235例病人的临床资料。其中行日间围手术期模式下经口腔前庭入路腔镜单侧甲状腺癌根治术125例（日间组），常规围手术期模式下经口腔前庭入路腔镜单侧甲状腺癌根治术110例（常规组）。对比分析两组病人的手术参数、术后并发症及住院参数等临床数据。结果    日间组125例病人中出现5例暂时性喉返神经损伤、1例感染及1例术后酒窝征，未出现其他并发症。常规组110例病人中出现5例暂时性喉返神经损伤，1例感染，1例术后味觉异常，1例暂时性甲状旁腺功能减退，未出现其他并发症。两组术后并发症对比差异无统计学意义。日间组手术预约时间及住院时间均短于常规组（P＜0.01），日间组住院费用更低（P＜0.01），病人满意度更高（P＜0.01）。结论    通过严格的多学科综合治疗协作组评估与围手术期管理，日间病房围手术期模式下行经口腔前庭入路腔镜甲状腺癌根治术能安全有效地开展，在取得良好的治疗效果和美容效果的同时，有效缩短病人的住院时间，降低住院费用，提升病人的住院满意度。

关键词: 经口腔前庭入路腔镜甲状腺癌根治术, 日间手术, 分化型甲状腺癌, 快速康复外科

Abstract: Feasibility and safety of transoral endoscopic thyroidectomy vestibular approach in perioperative mode of day surgery        CHEN Hang, LUO Yu-ting, GONG Zhi-xian,et al. Day Ward, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
Corresponding author：ZHU Xiao-ping，E-mail:13907915506@163.com
Abstract    Objective    To analyze the feasibility，safety and advantages of transoral endoscopic thyroidectomy vestibular approach in perioperative mode of day surgery. Methods    A retrospective analysis was performed on the clinical data of 235 patients undergoing transoral endoscopic thyroidectomy vestibular approach in the First Affiliated Hospital of Nanchang University from January 2019 to April 2021.Among them，125 cases underwent transoral endoscopic thyroidectomy vestibular approach in perioperative mode of day surgery（day group），and 110 cases underwent transoral endoscopic thyroidectomy vestibular approach in conventional perioperative mode（routine group）.The clinical data of surgical parameters，postoperative complications and hospitalization parameters of the two groups were compared and analyzed. Results    In the day group，there were 5 cases of temporary recurrent laryngeal nerve injury，1 case of infection and 1 case of postoperative dimple syndrome，but no other complications.Among the 110 patients in the routine group，there were 5 cases of temporary recurrent laryngeal nerve injury，1 case of infection，1 case of abnormal taste after operation，and 1 case of temporary hypoparathyroidism，without other complications.There was no significant difference in postoperative complications between the two groups.The operation appointment time and hospital stay time in the day group were shorter than those in the routine group（P＜0.01）. Hospitalization costs were lower, and patient satisfaction was higher in the day group（P＜0.01）.Conclusion    Through rigorous MDT diagnostic assessment and perioperative management，transoral endoscopic thyroidectomy vestibular approach in perioperative mode of day surgery can be safe and effective to carry out the cavity mirror thyroid cancer radical，and good treatment effect and cosmetic effect can be obtained at the same time，which effectively shorten the hospitalization time of patients, reduce hospitalization expenses，and improve patient satisfaction with hospital.

Key words: transoral endoscopic thyroidectomy vestibular approach, day surgery, differentiated thyroid cancer, enhanced recovery after surgery