Objective: To evaluate the advantages and clinical value regarding the ambulatory surgery for thyroid.
Methods: A total of 66 patients (including 16 cases of differentiated thyroid cancer, 50 cases of benign thyroid tumors) from June 2014 to April 2015 in Center for Ambulatory Surgery of Xiangya Hospital were enrolled for this study and served as an exprimental group. All patients met pre-established ambulatory surgery criteria for thyroid. According to medical records, 133 patients with similar conditions to the experimental group were chosen as a control group. All of operations in two groups were completed by the same doctors. The time of operation, amount of bleeding during operation, drainage after the operation, operation method, resection range, histological features, surgical complications, average days of hospitalization, average hospitalization cost, the rate of re-admission and the satisfaction of patients were compared between the 2 groups.
Results: Time of operation and amount of bleeding during operation were not significantly different between the 2 groups (P>0.05). In terms of drainage after operation and resection range, there were obvious differences between the 2 groups (P<0.05). The resection range and the amounts of drainage in the experimental group were less than those in the control group. More patients in the experimental group chose endoscopic thyroid surgery compared with those in the control group (P<0.05). The rate of surgical complications and re-admission was not different (P>0.05), but average days of hospitalization and average hospitalization cost were less in the experimental group (P<0.05). Patients were satisfied with ambulatory thyroid surgery (P<0.05).
Conclusion: Under certain criteria, ambulatory surgery for thyroid is a new operation method, which is safe, high-efficient, convenient, economy and time-efficient. It can decrease average days of hospitalization and average hospitalization cost obviously, and provide a reasonable choice for certain patients. The selection of endoscopic thyroid surgery was not conflict with selection of ambulatory thyroid surgery.
目的：探讨甲状腺日间手术的优点及临床应用前景。方法：回顾性分析中南大学湘雅医院2014年6月至2015年4月按日间手术标准收治的66例患者(包括分化型甲状腺癌 16例，甲状腺良性肿块50例)作为实验组，在同时期住院病历中，选取同样符合日间手术标准的133例(包括分化型甲状腺癌50例，甲状腺良性肿块83例)作为对照组，两组患者的手术均由同一医生及其团队完成，并对两组患者术中情况、术后并发症发生情况、人均住院时间、人均住院费用、再入院率、患者满意度等方面进行比较。结果：两组间手术时间与术中出血量差异无统计学意义(均P>0.05)；两组在术中放置引流管及手术切除范围方面，实验组手术切除范围较对照组小(P<0.05)，放置引流管患者明显较对照组少(P<0.05)；在手术方式的选择上，实验组患者选择腔镜手术的比例较对照组大(P<0.05)；两组间术后并发症发生率以及再入院率差异无统计学意义(均P>0.05)；实验组人均住院时间较对照组明显缩短(P<0.05)，人均住院费用较对照组明显降低(P<0.05)。实验组患者满意度较对照组患者高(P<0.05)。结论：甲状腺日间手术在严格控制适应证的情况下，具有安全高效、方便快捷的特点，能明显降低住院时间和住院费用，是一种合理的选择，甲状腺腔镜手术的选择和日间手术的选择无冲突。.