Endoscopic thyroidectomy via areola approach for stage T1 papillary thyroid carcinoma: feasibility, safety, and oncologic outcomes.
Endoscopic thyroidectomy via areola approach for stage T1 papillary thyroid carcinoma: feasibility, safety, and oncologic outcomes.
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DOI：
10.3389/fendo.2023.1212490
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发表时间：
2023
影响因子：
5.2
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中科院分区：
文献类型：
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评价经乳晕入路内镜甲状腺切除术（ETAA）与传统开放性甲状腺切除术（COT）治疗T1期甲状腺乳头状癌（PTC）的可行性、安全性和肿瘤学结局。2021年1月至2022年6月期间，共有1204例确诊为PTC的患者接受了筛查，其中138例患者在倾向评分匹配后入选研究人群（ETAA组92例患者，COT组46例患者）。该研究包括使用R软件收集和分析临床病理特征、术中结局、术后结局、并发症和随访数据。ETAA组的手术时间长于COT组（160.42 ± 32.21 min vs. 121.93 ± 29.78 min，p < 0.0001）。然而，两组在术中失血量、手术切除范围、清扫淋巴结数量、转移淋巴结数量和甲状旁腺自体移植率方面无显著差异。ETAA组的术后引流量和C反应蛋白水平高于COT组，但在24小时视觉模拟量表评分、白色血细胞计数、引流量持续时间或术后住院时间方面无显著差异。两组的并发症发生率相似，没有观察到永久性喉返神经麻痹或甲状旁腺功能减退。接受ETAA的患者比接受COT的患者报告了更高的美容满意度和生活质量。在随访阶段，COT组中仅1例患者发生了需要再次手术的颈外侧淋巴结受累。对于T1期PTC患者，ETAA是一种安全可行的手术方法，在肿瘤学完整性方面提供了与COT相似的结果，同时避免了颈部瘢痕，具有良好的美容效果。中国临床试验注册中心，标识符ChiCTR 2300077109
To evaluate the feasibility, safety, and oncologic outcomes associated with endoscopic thyroidectomy via the areolar approach (ETAA), compared with conventional open thyroidectomy (COT) for the treatment of stage T1 papillary thyroid carcinoma (PTC). Between January 2021 and June 2022, a total of 1204 patients diagnosed with PTC underwent screening, out of which 138 patients were selected for inclusion in the study population after propensity score matching (92 patients in the ETAA group and 46 patients in the COT group). The study included the collection and analysis of clinicopathologic characteristics, intraoperative outcomes, postoperative outcomes, complications, and follow-up data using R software. The operative time for the ETAA group was longer than that for the COT group (160.42 ± 32.21 min vs. 121.93 ± 29.78 min, p < 0.0001). However, there were no significant differences between the two groups in terms of intraoperative blood loss, the extent of surgical resection, the number of dissected lymph nodes, the number of metastatic lymph nodes, and the rate of parathyroid autotransplantation. Postoperative drainage and C-reactive protein levels were higher in the ETAA group than in the COT group, but there were no significant differences in 24-hour visual analogue scale scores, white blood cell counts, drainage duration, or postoperative hospital stay. Complication rates were similar between the two groups, and no permanent recurrent laryngeal nerve palsy or hypoparathyroidism was observed. Patients who underwent ETAA reported greater cosmetic satisfaction and quality of life than those who underwent COT. During the follow-up phase, only one patient in the COT group developed lateral cervical lymph node involvement requiring reoperation. ETAA is a safe and feasible surgical method for patients with stage T1 PTC, providing results similar to COT in terms of oncologic completeness, while avoiding neck scars, with excellent cosmetic effects. Chinese Clinical Trial Registry center, identifier ChiCTR2300077109
影响因子：
5.2
作者：
Zhang D;Wang C;Wang T;Du R;Li K;Yang M;Xue G;Dionigi G;Sun H
通讯作者：
Sun H
影响因子：
3.2
作者：
He J;Zhang C;Zhang Z;Xia F
通讯作者：
Xia F
影响因子：
5.2
作者：
通讯作者：
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