经胸前入路腔镜单侧甲状腺癌整块切除与常规腔镜手术的临床疗效比较OA

Objective:To investigate the clinical efficacy of transthoracic endoscopic en bloc resection versus conventional en-doscopic surgery for unilateral papillary thyroid carcinoma.Methods:A retrospective analysis was conducted on the clinical data of 86 patients with unilateral papillary thyroid carcinoma admitted from Jun.2021 to Jul.2024.All patients underwent transthoracic en-doscopic radical resection of unilateral thyroid carcinoma,and were divided into an en bloc resection group and a conventional group,with 43 patients in each group.The operative time,intraoperative blood loss,postoperative drainage volume,pathological indicators(number of lymph nodes dissected,number of positive lymph nodes),postoperative pain score,complications,and parathyroid function indicators(postoperative parathyroid hormone and serum calcium levels)were compared between the two groups.Results:The operative time in the en bloc resection group was shorter than that in the conventional group[(85.6±10.2)min vs.(96.8±12.1)min],the in-traoperative blood loss[(18.7±3.9)mL vs.(22.4±4.1)mL]and postoperative drainage volume[(41.2±6.8)mL vs.(47.6±7.2)mL]in the en bloc resection group were less than those in the conventional group,and the differences were statistically significant(P<0.001).There were no statistically significant differences between the two groups in the number of lymph nodes dissected[(3.3±0.5)vs.(3.2±0.6)]and the number of positive lymph nodes[(0.9±0.3)vs.(0.8±0.3)](P>0.05).There were no statistically significant differences in pain scores on the 1st and 2nd postoperative days or the total incidence of complications between the two groups(P>0.05).The parathyroid hormone level[(35.6±8.1)pg/mL vs.(28.2±7.5)pg/mL]and serum calcium level[(2.18±0.12)mmol/L vs.(2.05±0.15)mmol/L]in the en bloc resection group at 24 h postoperatively were higher than those in the conven-tional group(P<0.05).There were no statistically significant differences in the incidence of hypocalcemia between the two groups(P>0.05).Conclusions:Transthoracic endoscopic en bloc resection for unilateral thyroid cancer has certain advantages in shortening the operative time,reducing intraoperative blood loss and postoperative drainage volume.It helps to clearly expose the recurrent laryn-geal nerve and protect parathyroid function during the operation,without increasing the incidence of complications or affecting the safety of tumor radical treatment.