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山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (1): 45-48.doi: 10.6040/j.issn.1671-7554.0.2020.1240

• 临床医学 • 上一篇    下一篇

达芬奇机器人在儿童及青少年甲状腺癌中的应用

庄大勇,贺青卿,李小磊,周鹏,岳涛,徐婧   

  1. 中国人民解放军联勤保障部队第九六〇医院甲状腺乳腺外科, 山东 济南 250031
  • 发布日期:2021-01-09
  • 通讯作者: 贺青卿. E-mail:heqingqing@yeah.net
  • 基金资助:
    国家重点研发计划(2019YFC0119205);国家自然科学基金(81702448);解放军第九六〇医院院长基金(2016ZD02、2017MS04)

Application of da Vinci robotic thyroidectomy for thyroid cancer in children and adolescents

ZHUANG Dayong, HE Qingqing, LI Xiaolei, ZHOU Peng, YUE Tao, XU Jing   

  1. Department of Thyroid and Breast Surgery, The 960th Hospital of the PLA Joint Logistics Support Force, Jinan 250031, Shandong, China
  • Published:2021-01-09

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摘要： 目的 探讨经双侧腋乳径路(BABA)达芬奇机器人治疗儿童及青少年甲状腺癌的手术安全性和疗效。 方法 回顾性分析2015年4月至2020年8月通过达芬奇机器人手术治疗45例儿童及青少年甲状腺癌的临床资料,其中男12例,女33例,13~22岁,平均(18.49±3.38)岁,均行达芬奇甲状腺癌根治手术。术后评估机器人甲状腺手术的安全性及肿瘤切除的彻底性。术后采用门诊复诊、电话等方式进行随访,1个月采用视觉数字评分系统评估切口美容效果。 结果 45例儿童及青少年甲状腺癌患者均顺利完成经BABA入路达芬奇机器人甲状腺手术,无中转开放手术。术中平均清扫中央区淋巴结17.4枚/例,其中阳性淋巴结5.9枚/例;平均清扫侧区淋巴结18枚/例,阳性淋巴结4.6枚/例。术后未发生永久性喉返神经损伤和甲状旁腺功能减退、大出血和淋巴漏等严重并发症,患者平均住院(6.9±0.4)d。术后随访1~64个月,切口美容评分为(9.6±0.3)分,无1例复发。 结论 经双侧腋乳入路行达芬奇机器人甲状腺手术治疗儿童及青少年甲状腺癌患者是安全有效的,患者颈部完全无瘢痕,可以达到满意的美容效果,减少术后心理创伤,提高患者的生存质量。

关键词: 达芬奇机器人手术系统, 儿童及青少年, 甲状腺癌, 甲状腺切除术

Abstract: Objective To explore the surgical safety and oncological completeness of da Vinci robotic thyroidectomy via bilateral axillary approach for children and adolescents with thyroid cancer. Methods The clinical data of 45 cases of thyroid cancer treated with da Vinci robotic thyroidectomy were collected and reviewed. The patients included 12 boys and 33 girls, aged 13 to 22 years, average(18.49±3.38)years. The surgical safety and oncological completeness were evaluated postoperatively. All patients were followed up by outpatient visits and telephone calls. The cosmetic outcomes were evaluated with numerical scoring system 1 month after operation. Results All operations were successful, with no conversion to open surgery. An average of 17.4 lymph nodes in the central area/case were resected, 5.9 of which were positive; an average of 18 lymph nodes/case in the lateral area were resected, 4.6 of which were positive. No serious complications such as permanent recurrent laryngeal nerve injury, hypoparathyroidism, hemorrhage or chylous leakage occurred. The average hospital stay was(6.9±0.4)days. In a postoperative follow-up of 1 to 64 months, the incision cosmetic score was(9.6±0.3). No recurrence happened. Conclusion The da Vinci robotic thyroidectomy via bilateral axillary breast approach is safe and effective for the treatment of thyroid cancer in children and adolescents. It can leave no scar on patients neck, achieve satisfactory cosmetic effects, reduce postoperative psychological trauma, and improve patients quality of life.

Key words: da Vinci surgical system, Children and adolescents, Thyroid cancer, Thyroidectomy

中图分类号: 

  • R736.1
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