Clinical efficacy analysis of thyroid surgery via the sternocleidomastoid muscle approach through a lateral cervical incision

XI Min-gang; JING Jia; HUO Yun-feng; ZHANG Jin

doi:10.11659/jjssx.08E024043

您当前的位置：

首页 >

文章列表页 >

Clinical efficacy analysis of thyroid surgery via the sternocleidomastoid muscle approach through a lateral cervical incision

Clinical Research | 更新时间：2025-06-17

- Clinical efficacy analysis of thyroid surgery via the sternocleidomastoid muscle approach through a lateral cervical incision
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 6, Pages: 530-534(2025)
- 作者机构：
  
  1.山西医科大学附属运城市中心医院甲状腺外科，山西运城 044000
  2.山西医科大学第一医院甲状腺外科，山西太原 030001
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.08E024043
  CLC： R653.1
- Received：12 August 2024，
  
  Published：25 June 2025
- 稿件说明：
移动端阅览
席敏岗,景佳,霍云峰等.经颈侧方切口胸锁乳突肌入路甲状腺手术的临床效果分析[J].局解手术学杂志,2025,34(06):530-534.

XI Min-gang,JING Jia,HUO Yun-feng,et al.Clinical efficacy analysis of thyroid surgery via the sternocleidomastoid muscle approach through a lateral cervical incision[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):530-534.
席敏岗,景佳,霍云峰等.经颈侧方切口胸锁乳突肌入路甲状腺手术的临床效果分析[J].局解手术学杂志,2025,34(06):530-534. DOI： 10.11659/jjssx.08E024043.

XI Min-gang,JING Jia,HUO Yun-feng,et al.Clinical efficacy analysis of thyroid surgery via the sternocleidomastoid muscle approach through a lateral cervical incision[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):530-534. DOI： 10.11659/jjssx.08E024043.

摘要

目的

系统性评估经颈侧方切口胸锁乳突肌入路甲状腺手术的临床效果。

方法

纳入2022年6月至2023年6月在山西医科大学附属运城市中心医院和山西医科大学第一医院接受甲状腺手术的患者286例，根据切口入路方式分为侧方切口组（102例）和正中切口组（184例）。比较2组患者术中出血量、术后恢复时间、术中神经监测信号变化、术后疼痛视觉模拟量表（VAS）评分、生活质量评分和术后并发症等临床数据。

结果

侧方切口组患者的术中出血量显著低于正中切口组（

=0.03），术后恢复时间显著短于正中切口组（

=0.01）。术中喉返神经监测显示，侧方切口组患者的神经信号残余幅度显著大于正中切口组（

0.05），神经信号潜伏期变化显著小于正中切口组（

0.05）。侧方切口组患者术后3 d和7 d的VAS评分显著低于正中切口组（

0.05）。侧方切口组患者术后3个月和1年的生活质量评分均显著高于正中切口组（

0.05）。2组患者术后并发症发生率比较，差异无统计学意义（

=0.15）。

结论

经颈侧方切口胸锁乳突肌入路甲状腺手术疗效确切，可减少术中出血，缩短术后恢复时间，减轻术后疼痛，提高患者生活质量。

Abstract

Objective

To systematically evaluate the clinical efficacy of thyroid surgery via the sternocleidomastoid muscle approach with lateral cervical incision.

Methods

A total of 286 patients undergoing thyroid surgery in Yuncheng Central Hospital Affiliated to Shanxi Medical University and the First Hospital of Shanxi Medical University from June 2022 to June 2023 were enrolled，and were divided into the lateral incision group （102 cases） and the median incision group （184 cases） according to the surgical approach. The clinical data including intraoperative bleeding volume，postoperative recovery time，intraoperative neuromonitoring signal changes，postoperative pain visual analogue scale （VAS） score，quality of life score，and postoperative complications of patients were compared between the two groups.

Results

The intraoperative bleeding volume of patients in the lateral incision group was significantly lower than that in the median incision group （

=0.03），and the postoperative recovery time was significantly shorter than that in the median incision group （

=0.01）.Intraoperative monitoring of the recurrent laryngeal nerve showed that the residual amplitude of nerve signals in the lateral incision group was significantly greater than that in the median incision group （

0.05），and the change in nerve signals latency was significantly smaller than that in the median incision group （

0.05）. The VAS scores of patients in the lateral incision group 3 days and 7 days after surgery were significantly lower than those in the median incision group （

0.05）. The quality of life scores of patients in the lateral incision group 3 months and 1 year after surgery were significantly higher than those in the median incision group （

0.05）. There was no statistically significant difference in the incidence of postoperative complications of patients between the two groups （

=0.15）.

Conclusion

Thyroid surgery via the sternocleidomastoid muscle approach with lateral cervical incision has definite therapeutic effects，which can reduce intraoperative bleeding，shorten the postoperative recovery time，alleviate postoperative pain，and improve the quality of life of patients.

关键词

Keywords

references

Tan C ， Cheah W ， Delbridge L . “Scarless” （in the neck） endoscopic thyroidectomy （SET）： an evidence-based review of published techniques ［J］. World J Surg ， 2008 ， 32 （ 7 ）： 1349 - 1357 . doi： 10.1007/s00268-008-9555-3 http://dx.doi.org/10.1007/s00268-008-9555-3 .

谢治年，夏露，廖芯艺，等 . 颈侧方切口手术治疗甲状腺良性肿瘤的效果分析［J］. 现代医药卫生， 2024 ， 40 （ 9 ）： 1527 - 1529 . doi： 10.3969/j.issn.1009-5519.2024.09.019 http://dx.doi.org/10.3969/j.issn.1009-5519.2024.09.019 .

Jiang Z ， Zhang W ， Jiang D ， et al . Clinical benefits of scarless endoscopic thyroidectomy： an expert's experience ［J］. World J Surg ， 2011 ， 35 （ 3 ）： 553 - 557 . doi： 10.1007/s00268-010-0905-6 http://dx.doi.org/10.1007/s00268-010-0905-6 .

孙世波，孙铁为，王峰，等 . 内镜下甲状腺手术的初步体会［J］. 腹腔镜外科杂志， 2004 ， 9 （ 4 ）： 215 - 220 . doi： 10.3969/j.issn.1009-6612.2004.04.024 http://dx.doi.org/10.3969/j.issn.1009-6612.2004.04.024 .

Alvarado R ， McMullen T ， Sidhu S ， et al . Minimally invasive thyroid surgery for single nodules： an evidence-based review of the lateral mini-incision technique ［J］. World J Surg ， 2008 ， 32 （ 7 ）： 1341 - 1348 . doi： 10.1007/s00268-008-9554-4 http://dx.doi.org/10.1007/s00268-008-9554-4 .

Feng W ， Feng Y ， Diao Q ， et al . Advantages of small incision surgery in thyroid tumors ［J］. Evid Based Complement Alternat Med ， 2022 ： 7794819 . doi： 10.1155/2022/7794819 http://dx.doi.org/10.1155/2022/7794819 .

Jiang B ， Qu C ， Jiang C ， et al . Comparison of supraclavicular oblique incision with traditional low collar incision approach for thyroidectomy in differentiated thyroid cancer ［J］. Front Oncol ， 2022 ， 12 ： 842981 . doi： 10.3389/fonc.2022.842981 http://dx.doi.org/10.3389/fonc.2022.842981 .

邬一军，朱峰，沈亦斌，等 . 颈侧方切口甲状腺手术的步骤及要点［J］. 浙江大学学报（医学版）， 2021 ， 50 （ 6 ）： 701 - 706 . doi： 10.3724/zdxbyxb-2021-0341 http://dx.doi.org/10.3724/zdxbyxb-2021-0341 .

Choe J ， Kim S ， Chung K ， et al . Endoscopic thyroidectomy using a new bilateral axillo-breast approach ［J］. World J Surg ， 2007 ， 31 （ 3 ）： 601 - 606 . doi： 10.1007/s00268-006-0481-y http://dx.doi.org/10.1007/s00268-006-0481-y .

Palazzo F ， Sebag F ， Henry J . Endocrine surgical technique： endoscopic thyroidectomy via the lateral approach ［J］. Surg Endosc ， 2006 ， 20 （ 2 ）： 339 - 342 . doi： 10.1007/s00464-005-0385-1 http://dx.doi.org/10.1007/s00464-005-0385-1 .

王田甜 . 经胸锁乳突肌前缘入路甲状腺手术颈前区功能保护的临床研究［D］. 郑州：河南大学， 2023 .

Singaporewalla R ， Tan B ， Rao A . The lateral "backdoor" approach to open thyroid surgery： a comparative study ［J］. Asian J Surg ， 2017 ， 41 （ 4 ）： 384 - 388 . doi： 10.1016/j.asjsur.2017.05.003 http://dx.doi.org/10.1016/j.asjsur.2017.05.003 .

Harris S . Thyroid and parathyroid surgical complications ［J］. Am J Surg ， 1992 ， 163 （ 5 ）： 476 - 478 . doi： 10.1016/0002-9610（92）90391-4 http://dx.doi.org/10.1016/0002-9610（92）90391-4 .

Napolitano C ， Vix M ， Mutter D ， et al . Thyroid and parathyroid surgery： is the medial approach truly elective？ Technique and advantage of the lateral approach ［J］. Minerva Chir ， 1997 ， 52 （ 11 ）： 1393 - 1395 .

Jin XX ， Zhang QY ， Gao C ， et al . Thyroidectomy using the lateral cervical small incision approach for early thyroid cancer ［J］. Clin Cosmet Investig Dermatol ， 2022 ， 15 ： 713 - 720 . doi： 10.2147/CCID.S358959 http://dx.doi.org/10.2147/CCID.S358959 .

Ikeda Y ， Takami H ， Niimi M ， et al . Endoscopic thyroidectomy by the axillary approach ［J］. Surg Endosc ， 2001 ， 15 （ 11 ）： 1362 - 1364 . doi： 10.1007/s004640080139 http://dx.doi.org/10.1007/s004640080139 .

Ikeda Y ， Takami H ， Sasaki Y ， et al . Clinical benefits in endoscopic thyroidectomy by the axillary approach ［J］. J Am Coll Surg ， 2003 ， 196 （ 2 ）： 189 - 195 . doi： 10.1016/S1072-7515（02）01665-4 http://dx.doi.org/10.1016/S1072-7515（02）01665-4 .

Rafferty M ， Miller I ， Timon C . Minimal incision for open thyroidectomy ［J］. Otolaryngol Head Neck Surg ， 2004 ， 135 （ 2 ）： 295 - 298 . doi： 10.1016/j.otohns.2006.03.013 http://dx.doi.org/10.1016/j.otohns.2006.03.013 .

Wilhelm T ， Metzig A. Video . Endoscopic minimally invasive thyroidectomy： first clinical experience ［J］. Surg Endosc ， 2010 ， 24 （ 7 ）： 1757 - 1758 . doi： 10.1007/s00464-009-0820-9 http://dx.doi.org/10.1007/s00464-009-0820-9 .

Vries L ， Aykan D ， Lodewijk L ， et al . Outcomes of minimally invasive thyroid surgery-a systematic review and meta-analysis ［J］. Front Endocrinol ， 2021 ， 12 ： 719397 . doi： 10.3389/fendo.2021.719397 http://dx.doi.org/10.3389/fendo.2021.719397 .

孙颖，赵彦广，吴剑，等 . 甲状腺微小乳头状癌与颈部淋巴结转移的相关性探讨［J］. 局解手术学杂志， 2019 ， 28 （ 2 ）： 133 - 138 . doi： 10.11659/jjssx.12E018041 http://dx.doi.org/10.11659/jjssx.12E018041 .

Ikeda Y ， Takami H ， Tajima G ， et al . Total endoscopic thyroidectomy： axillary or anterior chest approach ［J］. Biomed Pharmacother ， 2002 ， 56 （ Suppl 1 ）： 72s - 78s . doi： 10.1016/s0753-3322（02）00274-3 http://dx.doi.org/10.1016/s0753-3322（02）00274-3 .

刘佳，袁栩昕，郑惊雷 . 不同喉返神经保护方法在甲状腺癌术后复发再次手术中的效果［J］. 局解手术学杂志， 2022 ， 31 （ 6 ）： 532 - 536 . doi： 10.11659/jjssx.11E021105 http://dx.doi.org/10.11659/jjssx.11E021105 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Efficacy and safety of carotid endarterectomy in treatment of different neurological deficits

Efficacy and safety of pre-hospital use of hemagglutinin in patients with craniocerebral trauma and scalp laceration

Influence of body mass index on the analgesic effect of sufentanil in elderly patients after proximal femoral nail anti-rotation surgery

Comparison of different internal fixation systems in geriatric humerus surgical neck fractures

Ultrasonic anatomical study and clinical application of stellate ganglion block via C₇ transverse process

Related Author

ZHU Kai-qiang

LI Zhong-lin

XIE Man-yi

ZHANG He

TANG Hua-Lei

YI Lan

ZHANG Pei-wen

PENG Shan

Related Institution

Department of Neurosurgery,the Affiliated Hospital of Xuzhou Medical University

Department of Emergency,Wuhan Central Hospital

Department of Endocrinology,Wuhan Central Hospital

Department of Anesthesiology，Nanjing Drum Tower Hospital Group Suqian Hospital

Department of Traumatic Orthopaedics， Kunshan Hospital Affiliated to Jiangsu University， Kunshan Jiangsu

⁰