目的:比较无充气腋窝入路和颈前开放入路甲状腺癌根治术对甲状旁腺功能及中央区淋巴结清扫水平的影响.方法:回顾性分析2021年1月至2022年6月我院收治的80例甲状腺乳头状癌患者的临床资料,其中40例行颈前开放入路甲状腺癌根治术(开放组),40例行无充气腋窝入路甲状腺癌根治术(腋窝组),对比两组术前和术后血清全段甲状旁腺激素(siPTH)水平、血清钙水平及中央区淋巴结清扫个数.结果:两组术前siPTH和血清钙水平比较差异无统计学意义(P>0.05),两组术后siPTH水平虽有降低,但均在正常范围,两组术后血清钙均值也在正常范围,两组术后siPTH及血清钙水平比较差异无统计学意义(P>0.05).开放组中央区淋巴结清扫数量多于腋窝组(P<0.05).结论:两种入路甲状腺癌根治术对甲状旁腺功能的影响无明显差异,但传统颈前开放入路术式较无充气腋窝入路术式对清扫中央区淋巴结更有利.
Objective:To compare the effect of gasless unilateral axillary approach(GUAA)and open anterior cervical approach(O AC A)on parathyroid function and dissection level of central lymph nodes in radical thyroidectomy for thyroid cancer.Methods:A retrospective analysis was conducted on the clinical data of 80 patients with papillary thyroid carcinoma admitted to our hospital from January 2021 to June 2022.Among them,40 cases underwent radical thyroidectomy by OACA(open group)and 40 cases underwent radical thyroidectomy by GUAA(axillary group).The preoperative and postoperative siPTH level,serum calcium level,and dissection number of central lymph nodes were compared between the two groups.Results:There were no statistically significant differences in preoperative siPTH and serum calcium levels between the two groups(P>0.05).After operation,siPTH levels decreased in the two groups,but they were all within the normal range,and the mean postoperative serum calcium levels in both groups were also within the normal range.There were no statistically significant differences in postoperative siPTH and serum calcium levels between the two groups(P>0.05).The dissection number of central lymph nodes in the open group was higher than that in the axillary group(P<0.05).Conclusion:There is no significant difference in the impact on parathyroid function between the two approaches for radical thyroidectomy,but the traditional OACA is more advantageous for clearing central lymph nodes than GUAA.