| 摘要: |
| ［摘要］ 目的 对5例接受经口前庭入路和双侧腋乳入路（BABA）联合的达芬奇机器人辅助甲状腺切除术治疗的甲状腺乳头状癌（PTC）患者的临床资料进行总结，观察该术式的临床效果。方法 选择2023年3月至2024年3月空军军医大学唐都医院普外科收治的5例PTC患者，临床分期均为cN1b期，伴颈部淋巴结转移（LNM）。患者采用经口前庭入路机器人甲状腺切除术（TORTVA）行甲状腺切除及颈部Ⅳ、Ⅴ、Ⅵ区淋巴结清扫，然后通过BABA行颈部Ⅱ、Ⅲ区淋巴结清扫。对术中指标及术后并发症和美容效果进行分析。结果 5例患者手术均成功，手术时间为（444.6±82.9）min。在中央区淋巴结清扫术中，切除淋巴结数和阳性淋巴结数分别为（15.6±8.6）个和（5.0±2.0）个。在颈侧淋巴结清扫术中，切除淋巴结数和阳性淋巴结数分别为（20.4±8.3）个和（3.0±1.4）个。2例患者术后出现轻度流涎，约1个月后自愈。所有患者术后均无血肿和明显皮下气肿。患者术后1周的美容满意度评分为（4.6±0.5）分，美容效果满意。结论 经口前庭入路和BABA联合的达芬奇机器人辅助甲状腺切除术治疗PTC安全有效，美容效果好，术后并发症少。 |
| 关键词: 甲状腺乳头状癌 达芬奇机器人 经口前庭入路机器人甲状腺切除术 双侧腋乳入路 中央区淋巴结清扫术 颈侧淋巴结清扫术 |
| DOI：10.3969/j.issn.1674-3806.2025.08.09 |
| 分类号:R 653 |
| 基金项目:陕西自然科学基础研究计划项目（编号：2022JM-604） |
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| Observation on clinical outcomes of combining transoral vestibular approach with bilateral axillo-breast approach for da Vinci robot-assisted thyroidectomy in 5 patients with papillary thyroid carcinoma |
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YANG Xiaozhou, YANG Xiaojun, HE Xianli, TANG Haili, ZHAO Huadong
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Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi′an 710038, China
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| Abstract: |
| ［Abstract］ Objective To summarize the clinical data of 5 patients with papillary thyroid carcinoma(PTC) who underwent da Vinci robot-assisted thyroidectomy via combining transoral vestibular approach with bilateral axillo-breast approach(BABA), and to observe the clinical effectiveness of the combined operation. Methods Five PTC patients with clinical stage of cN1b and cervical lymph node metastasis(LNM) who were admitted to Department of General Surgery, Tangdu Hospital, Air Force Medical University from March 2023 to March 2024 were selected. The patients underwent thyroidectomy and lymph node dissection in the areas of Ⅳ, Ⅴ and Ⅵ of the neck via transoral robotic thyroidectomy vestibular approach(TORTVA), and then lymph node dissection in the areas of Ⅱ and Ⅲ of the neck was performed through BABA. The intraoperative indicators, postoperative complications and cosmetic effects were analyzed. Results The operations in all five patients were successful, and the operation time was (444.6±82.9)min. In central neck dissection, the number of resected lymph nodes and the number of positive lymph nodes were (15.6±8.6) and (5.0±2.0)nodes, respectively. In lateral neck dissection, the number of resected lymph nodes and the number of positive lymph nodes were (20.4±8.3) and (3.0±1.4)nodes, respectively. Two patients experienced mild salivation after operation, which healed spontaneously about 1 month later. None of the patients had hematoma or obvious subcutaneous emphysema after operation. One week after operation, the cosmetic satisfaction scores of the patients were (4.6±0.5)points, and the patients were satisfied with the cosmetic effect. Conclusion Combining transoral vestibular approach with BABA for da Vinci robot-assisted thyroidectomy is safe and effective in treatment of PTC, with good cosmetic effect and less postoperative complications. |
| Key words: Papillary thyroid carcinoma(PTC) da Vinci robot Transoral robotic thyroidectomy vestibular approach(TORTVA) Bilateral axillo-breast approach(BABA) Central neck dissection Lateral neck dissection |
