[1]钟玲,张晔,杜俊泽,等.防粘膜在机器人甲状腺癌手术中的应用效果[J].第三军医大学学报,2020,42(12):1209-1214.
 ZHONG Ling,ZHANG Ye,DU Junze,et al.Application of anti-adhesion film in robotic thyroid cancer surgery alleviates postoperative soft tissue adhesion and swallowing discomfort[J].J Third Mil Med Univ,2020,42(12):1209-1214.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第12期
页码:
1209-1214
栏目:
临床医学
出版日期:
2020-06-30

文章信息/Info

Title:
Application of anti-adhesion film in robotic thyroid cancer surgery alleviates postoperative soft tissue adhesion and swallowing discomfort
作者:
钟玲张晔杜俊泽崔翔曾令娟张毅姜军范林军
陆军军医大学(第三军医大学)第一附属医院乳腺甲状腺外科
Author(s):
ZHONG Ling ZHANG Ye DU Junze CUI Xiang ZENG Lingjuan ZHANG Yi JIANG Jun FAN Linjun

Department of Breast and Thyroid Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
 

关键词:
甲状腺癌机器人手术
Keywords:
anti-adhesion film thyroid cancer robotic surgery  
分类号:
R181.32;R608;R736.1
文献标志码:
A
摘要:

目的探讨防粘膜在机器人甲状腺癌手术中的防粘连效果。方法回顾性分析本院2016年1月至2018年12月接受达芬奇机器人甲状腺癌手术患者452例的临床资料及治疗效果,其中试验组228例在完成甲状腺切除以及淋巴结清扫后将防粘膜(可吸收医用膜)放置在气管前方后缝合颈白线。对照组224例除未使用防粘膜外其他操作与试验组相同。结果试验组吞咽不适状况评分在术后3、6个月均明显低于对照组。亚组分析结果显示,单侧甲状腺切除患者术后3、6、12个月其吞咽不适的评分两组间差异均无统计学意义(P>0.05)。甲状腺全切患者试验组与对照组的吞咽不适评分在术后3个月(P=0.00)、6个月(P=0.001)均明显低于对照组;试验组与对照组吞咽不适发生率(轻度+较重) 在术后3个月(P=0.004)、6个月(P=0.006)差异均有统计学意义,使用防粘膜后吞咽不适发生率均明显低于对照组。两组术后声音嘶哑和甲状旁腺功能减退发生率、引流量以及住院时间等方面差异均无统计学意义(P>0.05)。结论机器人甲状腺全切患者术中使用可吸收医用膜能有效减轻颈部软组织粘连,改善术后吞咽不适,提高患者术后生活质量。

Abstract:

ObjectiveTo investigate the anti-adhesion effect of anti-adhesion film in robotic thyroid cancer surgery. MethodsWe retrospectively analyzed the clinical data and treatment outcomes of 452 patients who underwent Da Vinci robotic surgery for thyroid cancer between January, 2016 and December, 2018. In 228 of the patients, anti-adhesion film (absorbable medical film) was placed on the trachea before thyroid resection and dissection of the lymph nodes (test group); the other 224 patients underwent identical surgical procedures but without the use of the anti-adhesion film (control group). ResultsThe scores for swallowing discomfort were significantly lower in the test group than in the control group at 3 and 6 months after the operation. Subgroup analysis showed that in the patients receiving unilateral thyroidectomy, the scores for swallowing discomfort did not differ significantly between the 2 groups at 3, 6, and 12 months postoperatively. In patients receiving total thyroidectomy, the scores were significantly lower in the test group than in the control group at 3 months (P=0.00) and 6 months (P=0.001), and the incidence of swallowing discomfort (either mild or severe) was also significantly lower in the test group at 3 months (74.6% vs 83.6%, P=0.004) and 6 months (24.2% vs 40.9%, P=0.006) after the operation. No significant differences were found in the incidences of postoperative hoarseness and hypoparathyroidism, drainage volume, or the length of hospital stay between the 2 groups. ConclusionThe use of absorbable medical film during robotic total thyroidectomy for thyroid cancer can effectively reduce neck soft tissue adhesion, lower the incidence of postoperative swallowing discomfort, and improve postoperative quality of life of the patients.
 

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更新日期/Last Update: 2020-06-19