探讨不同入路手术的完全腔镜甲状腺切除术(CET)治疗甲状腺癌的应用效果。

选取2017年3月至2019年2月90例接受CET治疗的甲状腺癌患者作为研究对象，并采用随机数表法分为腋乳组和胸乳组，各45例。采用统计软件SPSS 21.00进行数据分析，围术期各项指标用(±s)表示，采用独立t检验；总满意度、并发症发生情况采用χ²检验或Fisher精确检验。P<0.05为有差异统计学意义。

腋乳组手术时间、术中出血量、术后引流量、引流时间、术后住院时间、检出淋巴结个数等围术期指标均优于胸乳组，差异均有统计学意义(P<0.05)。腋乳组术后并发症发生率(11.1%)低于胸乳组(31.1%)，患者总满意度(97.8%)高于胸乳组(80.0%)，差异有统计学意义(P<0.05)。两组患者随访期间均无复发等情况发生。

改良腋乳入路相比胸乳入路具有手术时间短，术后引流液少，拔管时间短，患者满意度高，愈后良好等优点，可在临床推广使用。

To investigate the effect of complete endoscopic thyroidectomy (CET) with different approaches in the treatment of thyroid cancer.

A total of 90 thyroid cancer patients receiving CET treatment from March 2017 to February 2019 were selected as the research subjects, and randomly divided into axillary breast group and thoracic breast group, with 45 cases in each group, using random number table method. Data analysis with statistical software SPSS 21.00. Perioperative indicators were expressed as (±s), the independent t test was used. The total satisfaction and the incidence of complications were tested by χ² test or Fisher’s exact test. P<0.05 was considered statistically significant.

The perioperative indexes of axillary breast group, such as operative time, intraoperative blood loss, postoperative drainage volume, drainage time, postoperative hospital stay and the number of lymph nodes detected, were better than those of thoracic breast group, with statistical significance(P<0.05). The incidence of postoperative complications in the axillary breast milk group (11.1%) was lower than that in the breast milk group (31.1%), and the total satisfaction of patients (97.8%) was higher than that in the breast milk group (80.0%), with statistical significance (P<0.05). There was no recurrence in the two groups during the follow-up.

Compared with the thoracic approach, the modified axillary approach has the advantages of shorter operation time, less postoperative drainage fluid, shorter extubation time, higher patient satisfaction and better recovery, which can be widely used in clinical practice.