摘要
目的:研究单侧腺叶切除伴峡部切除术治疗T1/2cN0M0单侧MPTC的临床疗效及安全性。方法:研究对象为2019年1月至2020年12月于合肥市第二人民医院普外科收治的T1/2cN0M0单侧MPTC患者,按纳入排除标准选取51例接受甲状腺全切手术+预防性双侧Ⅵ区淋巴结清扫术的T1/2cN0M0单侧MPTC患者作为对照组;按1∶1比例,以性别、年龄±5岁、肿瘤-淋巴结-远处转移(TNM)分期匹配原则选取同期在本院接受单侧腺叶切除伴峡部切除术+预防性双侧Ⅵ区淋巴结清扫术的51例T1/2cN0M0单侧MPTC患者为观察组。比较两组手术时间、术中出血量、手术切口长度、引流量、拔出引流管天数、住院时间、术后并发症的发生率及术后无进展生存期(PFS)。结果:观察组患者的手术时间及手术切口较对照组短(P<0.05),且观察组患者术中出血量显著少于对照组(P<0.05);观察组患者手术后引流量显著少于对照组(P<0.05),且观察组患者手术后拔出引流管天数及住院时间较对照组短(P<0.05);观察组术后并发症发生率(11.76%)显著低于对照组术后并发症发生率(49.02%)(P<0.05);两组随访期间未见死亡、失访病例;对照组随访期间出现2例颈外淋巴结转移,平均生存时间为11个月,无进展生存者占96.08%;观察组随访期间3例复发、2例颈外淋巴转移,平均生存时间为11个月,无进展生存者占90.20%,两组无进展生存率比较差异无统计学意义(χ2=1.359、P=0.244)。结论:单侧腺叶切除伴峡部切除术能有效治疗T1/2cN0M0单侧MPTC,安全性较高,能有效降低术后并发症的发生率,进而有效改善患者的生活质量,且有效防止癌症复发。
Objective:To study the clinical efficacy and safety of unilateral lobectomy with isthmectomy in the treatment of T1/2cN0M0 unilateral multifocal papillary thyroid carcinoma(MPTC).Methods:Patients with T1/2cN0M0 unilateral MPTC who were admitted to the General Surgery Department,the Second People's Hospital of Hefei from January 2019 to December 2020 were selected as the research subjects.According to the inclusion and exclusion criteria,51 patients who underwent total thyroidectomy combined with prophylactic bilateral VI lymph node dissection were selected as the control group.According to the gender,age±5,and tumor-node-metastasis(TNM)stage matching principle,51 patients who underwent unilateral lobectomy combined with isthmectomy and prophylactic bilateral VI lymph node dissection in the hospital during the same period were selected as the observation group.The 2 groups were compared in terms of the operation time,intraoperative blood loss,length of the surgical incision,drainage volume,number of days of drainage tube removal,hospital stay,the incidence of postoperative complications,and postoperative progression-free survival(PFS).Results:The operation time,incision,intraoperative blood loss,postoperative drainage volume,number of days of drainage tube removal,and the hospital stay of the observation group were shorter/less than those of the control group(P<0.05).The incidence of postoperative complications in the observation group(11.76%)was significantly lower than that in the control group(49.02%)(P<0.05).No death or loss cases were found during follow-up.There were 2 cases of external cervical lymph node metastasis in the control group during the follow-up period,with an average survival time of 11 months and a PFS rate of 96.08%.There were 3 cases of recurrence and 2 cases of cervical lymph node metastasis in the observation group during the follow-up period,with an average survival time of 11 months and a PFS rate of 90.20%.The 2 groups had similar PFS(χ2=1.359,P=0.244).Conclusion:Unilateral lobectomy combined with isthmectomy is effective and safe in the treatment of T1/2cN0M0 unilateral MPTC,which can effectively reduce postoperative complications,thereby improving quality of life of the patients,and preventing recurrence.
作者
燕世德
胡开兵
胡钢
郭德胜
吴茂松
YAN Shide;HU Kaibing;HU Gang(The Second People's Hospital,Anhui Hefei 230032,China)
出处
《河北医学》
CAS
2023年第2期307-311,共5页
Hebei Medicine
基金
2020年度安徽省自然科学基金项目,(编号:2008085QH423)。
