[1]唐嘉晨,郝玲玲,秦晓茹,等.全腔镜下甲状腺乳头状癌并发症Meta分析[J].医学信息,2021,34(04):78-83.[doi:10.3969/j.issn.1006-1959.2021.04.021]
　TANG Jia-chen,HAO Ling-ling,QIN Xiao-ru,et al.Meta-analysis of Complications of Papillary Thyroid Carcinoma Under Full Laparoscopic Surgery[J].Medical Information,2021,34(04):78-83.[doi:10.3969/j.issn.1006-1959.2021.04.021]
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全腔镜下甲状腺乳头状癌并发症Meta分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年04期
页码:
78-83
栏目:
论著
出版日期:
2021-02-15

文章信息/Info

Title:
Meta-analysis of Complications of Papillary Thyroid Carcinoma Under Full Laparoscopic Surgery
文章编号:
1006-1959（2021）04-0078-06
作者:
唐嘉晨; 郝玲玲; 秦晓茹; 等
（1.华北理工大学研究生学院，河北 唐山 063000； 2.河北省人民医院，河北 石家庄 050000）
Author(s):
TANG Jia-chen; HAO Ling-ling; QIN Xiao-ru; et al.
(1.Graduate School of North China University Of Science and Technology,Tangshan 063000,Hebei,China; 2.Hebei Provincial People’s Hospital,Shijiazhuang 050000,Hebei,China)
关键词:
甲状腺癌; 全腔镜入路; 分化型甲状腺癌; 甲状腺乳头状癌; 甲状腺切除术
Keywords:
Thyroid carcinoma; Total laparoscopic approach; Differentiated thyroid cancer; Papillary thyroid carcinoma; Thyroidectomy
分类号:
R73
DOI:
10.3969/j.issn.1006-1959.2021.04.021
文献标志码:
A
摘要:
目的 分析国内外全腔镜手术与传统开放性手术治疗甲状腺乳头状癌术中清扫淋巴结数目及术后并发症，探讨全腔镜术后患者并发症发生情况。方法 本文通过中国知网（CNKI）、中国生物医学文献数据库（CBM）、PubMed、万方数据库、Embase、Web of Science和Cochrane Library等数据库，检索关键词“甲状腺”“甲状腺肿瘤”“全腔镜”“分化型甲状腺癌”“Thyroid carcinoma”“Papillary Thyroid Carcinoma”“Video-Assisted”“EndoscopicThyroidectomy”。结果 纳入了 2012年~2020年统计源及核心期刊发表高质量的国内文献11篇全腔镜治疗分化型甲状腺癌及2007年~2018年国内4篇、国外8篇全腔镜治疗甲状腺乳头状癌方面的文章进行 Meta 分析。最终纳入23篇文献，其中腔镜组1223例，开放组2399 例。腔镜组清扫淋巴结数目多于开放组（WMD=-0.45，95%CI：-0.08~-0.09，Z=2.47，P=0.01）；两组术后暂时性低钙血症发生率的相比，差异无统计学意义（OR=0.81，95%CI：0.64~1.03，Z=1.69，P=0.09）；腔镜组术后暂时性喉返神经损伤的可能性多于开放组（OR=1.97，95%CI：1.13~3.43，Z=4.64，P=0.00）；两组术后肿瘤复发率的相比，差异无统计学意义（OR=0.55，95%CI：0.23~1.35，Z=1.30，P=0.195），两组术后血肿形成的可能性相比，差异无统计学意义（OR=0.81，95%CI：0.64~1.03，Z= 0.73，P=0.47）。结论 全腔镜治疗甲状腺乳头状癌手术产生的术后并发症少，具有一定的安全性，术中清扫淋巴结较开放性手术彻底，降低了术后甲状腺乳头状癌患者复发及转移风险。
Abstract:
Objective To analyze the number of lymph node dissections and postoperative complications in the treatment of papillary thyroid carcinoma by full laparoscopic surgery and traditional open surgery at home and abroad.To discuss the complications of patients after total laparoscopy.Methods In this paper, through the China Knowledge Network (CNKI), China Biomedical Literature Database (CBM), PubMed, Wanfang Database, Embase, Web of Science and Cochrane Library, etc.Key words "thyroid", "thyroid tumor", "full endoscopy", "differentiated thyroid carcinoma", "Thyroid carcinoma", "Papillary Thyroid Carcinoma","Video-Assisted",and "EndoscopicThyroidectomy".Results Included 11 high-quality domestic articles published in statistical sources and core journals from 2012 to 2020 and 4 domestic articles from 2007 to 2018 in the treatment of differential.Meta-analysis of 8 foreign articles on the treatment of papillary thyroid carcinoma with full laparoscopic surgery.Finally, 23 articles were included, including 1223 cases in the endoscopy group and 2399 cases in the open group. The number of lymph nodes in the endoscopy group was more than that in the open group (WMD=-0.45, 95%CI: -0.08--0.09, Z=2.47, P=0.01);There was no statistically significant difference in the incidence of postoperative transient hypocalcemia between the two groups (OR=0.81, 95%CI: 0.64-1.03, Z=1.69, P=0.09);The possibility of transient recurrent laryngeal nerve injury in the laparoscopy group was more than that in the open group (OR=1.97, 95%CI: 1.13-3.43, Z=4.64, P=0.00);There was no statistically significant difference in the tumor recurrence rate between the two groups after surgery (OR=0.55, 95% CI: 0.23-1.35, Z=1.30, P=0.195). Compared with the possibility of postoperative hematoma formation in the two groups, The difference was not statistically significant (OR=0.81, 95% CI: 0.64-1.03, Z=0.73, P=0.47).Conclusion The full laparoscopic treatment of papillary thyroid carcinoma has fewer postoperative complications and is safe. Intraoperative lymph node dissection is more thorough than open surgery, which reduces the risk of recurrence and metastasis in patients with postoperative papillary thyroid carcinoma.

参考文献/References:

[1]齐鹏.腔镜甲状腺手术与传统开放手术治疗分化型甲状腺癌的临床对比研究[J].中西医结合心血管病电子杂志,2018,6(7):85. [2]李树年.腔镜手术对早期分化型甲状腺肿瘤患者的临床疗效[J].当代医学,2018,24(35):35-37. [3]祝玉祥,章佳新,蔡凤林,等.全腔镜手术与传统手术治疗早期分化型甲状腺癌的临床比较[J].中国普通外科杂志,2014,23(5):605-608. [4]雷大钊.全腔镜手术与传统手术治疗早期分化型甲状腺癌的临床效果比较[J].医学理论与实践,2017,30(13):1954-1955. [5]邱洪波,唐乐,窦刚,等.全腔镜手术与传统手术治疗早期分化型甲状腺腺癌的临床效果研究[J].河北医学,2018,24(10):1610-1614. [6]王薇,潘金强,陈辉,等.完全腔镜下甲状腺癌根治术与传统开放手术的临床效果对比分析[J].肿瘤学杂志,2017,23(12):1127-1130. [7]陈昌波,韩宽怀,杨建,等.完全乳晕入路腔镜甲状腺手术治疗早期分化型甲状腺癌的疗效分析[J].中华普外科手术学杂志(电子版),2019,13(2):190-192. [8]刘孝花.不同手术方法在治疗早期分化型甲状腺癌的临床效果[J].现代诊断与治疗,2018,29(16):2585-2587. [9]李思齐,吴涛,李燕,等.不同手术方法治疗早期分化型甲状腺癌的临床效果比较[J].昆明医科大学学报,2017,38(2):109-113. [10]张晓静,陈延松,王彬彬,等.甲状腺癌的腔镜手术治疗及临床有效性研究[J].中国医药科学,2017,7(24):200-202. [11]吴伟梁,毕铁男.全腔镜与开放甲状腺次全切除术治疗早期分化型甲状腺癌效果比较[J].中国乡村医药,2016,23(4):29-30. [12]Tan Z,Gu J,Han Q,et al.Comparison of Conventional Open Thyroidectomy and Endoscopic Thyroidectomy via Breast Approach for Papillary Thyroid Carcinoma[J].Int J Endocrinol,2015(2015):239610. [13]Xiang D,Xie L,Li Z,et al.Endoscopic thyroidectomy along with bilateral central neck dissection(ETBC)increases the risk of transient hypoparathyroidism for patients with thyroid carcinoma[J].Endocrine,2016,53(3):747-753. [14]Huang JK,Ma L,Song WH,et al.Quality of life and cosmetic result of single-port access endoscopic thyroidectomy via axillary approach in patients with papillary thyroid carcinoma[J].Onco Targets Ther,2016(9):4053-4059. [15]Ren X,Dai Z,Sha H,et al.Comparative study of endoscopic thyroidectomy via a breast approach versus conventional open thyroidectomy in papillary thyroid microcarcinoma patients[J].Biomedical Research,2017,12(28):5315-5320. [16]Chung YS,Choe JH,Kang KH,et al.Endoscopic thyroidectomy for thyroid malignancies:comparison with conventional open thyroidectomy[J].World J Surg,2007,31(12):2302-2306. [17]Hong HJ,Kim WS,Koh YW,et al.Endoscopic thyroidectomy via an axillo-breast approach without gas insufflation for benign thyroid nodules and micropapillary carcinomas:preliminary results[J].Yonsei Med J,2011,52(4):643-654. [18]Kim WW,Kim JS,Hur SM,et al.Is robotic surgery superior to endoscopic and open surgeries in thyroid cancer[J].World J Surg,2011,35(4):779-784. [19]Tae K,Ji YB,Cho SH,et al.Initial experience with a gasless unilateral axillo-breast or axillary approach endoscopic thyroidectomy for papillary thyroid microcarcinoma:comparison with conventional open thyroidectomy[J].Surg Laparosc Endosc Percutan Tech,2011,21(3):162-169. [20]Lee H,Lee J,Sung KY.Comparative study comparing endoscopic thyroidectomy using the axillary approach and open thyroidectomy for papillary thyroid microcarcinoma[J].World J Surg Oncol,2012(12):269. [21]Kim SK,Kang SY,Youn HJ,et al.Comparison of conventional thyroidectomy and endoscopic thyroidectomy via axillo-bilateral breast approach in papillary thyroid carcinoma patients[J].Surg Endosc,2016,30(8):3419-3425. [22]Lee MC,Park H,Lee BC,et al.Comparison of quality of life between open and endoscopic thyroidectomy for papillary thyroid cancer[J].Head Neck,2016,38(1):E827-E831. [23]Park KN,Jung CH,Mok JO,et al.Prospective comparative study of endoscopic via unilateral axillobreast approach versus open conventional total thyroidectomy in patients with papillary thyroid carcinoma[J].Surg Endosc,2016,30(9):3797-3801. [24]Gagner M.Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism[J].Br J Surg,1996,83(6):875. [25]Hüscher CS,Chiodini S,Napolitano C,et al.Endoscopic right thyroid lobectomy[J].Surg Endosc,1997,11(8):877. [26]徐荣,安媛,梁秦龙,等.小切口腔镜辅助下手术治疗分化型甲状腺癌[J].中国实用外科杂志,2012,32(S1):26-27. [27]高海楠,郝文伟,金洪飞,等.腔镜技术应用于分化型甲状腺癌手术治疗的近期疗效及适应证分析[J].中国医药指南,2018,16(36):191-192. [28]张情.微小分化型甲状腺癌的全腔镜与开放性手术的临床分析[D].新疆医科大学,2018. [29]Chen C,Huang S,Huang A,et al.Total endoscopic thyroidectomy versus conventional open thyroidectomy in thyroid cancer:a systematic review and meta-analysis[J].Ther Clin Risk Manag,2018,5(14):2349-2361.

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