Construction of a risk model for complications after endoscopic thyroidectomy through gasless unilateral axillary approach for thyroid tumors

ZHOU Mian; HE Yan; SHI Tong; ZHU Xiao-chao; CAI Jing

doi:10.11659/jjssx.08E025087

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Construction of a risk model for complications after endoscopic thyroidectomy through gasless unilateral axillary approach for thyroid tumors

Clinical Research | 更新时间：2026-03-17

- Construction of a risk model for complications after endoscopic thyroidectomy through gasless unilateral axillary approach for thyroid tumors
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 3, Pages: 254-258(2026)
- 作者机构：
  
  宿迁市第一人民医院普外甲乳科，江苏宿迁 223800
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.08E025087
  CLC： R736.1
- Received：22 August 2025，
  
  Published：25 March 2026
- 稿件说明：
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周腼,何岩,时通等.无充气腋窝入路腔镜甲状腺手术后并发症风险模型的构建[J].局解手术学杂志,2026,35(03):254-258.

ZHOU Mian,HE Yan,SHI Tong,et al.Construction of a risk model for complications after endoscopic thyroidectomy through gasless unilateral axillary approach for thyroid tumors[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(03):254-258.
周腼,何岩,时通等.无充气腋窝入路腔镜甲状腺手术后并发症风险模型的构建[J].局解手术学杂志,2026,35(03):254-258. DOI： 10.11659/jjssx.08E025087.

ZHOU Mian,HE Yan,SHI Tong,et al.Construction of a risk model for complications after endoscopic thyroidectomy through gasless unilateral axillary approach for thyroid tumors[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(03):254-258. DOI： 10.11659/jjssx.08E025087.

摘要

目的

探讨无充气腋窝入路腔镜甲状腺手术（ETGUA）后并发症发生的影响因素并构建其风险预测模型。

方法

回顾性分析2023年1月至2025年3月于我院接受ETGUA治疗的220例甲状腺肿瘤患者的临床资料。根据术后是否发生并发症将患者分为无并发症组（

=189）和并发症组（

=31）。采用单因素分析和多因素

Logistic

回归分析甲状腺肿瘤患者接受ETGUA治疗后发生并发症的影响因素，并据此构建

Logistic

回归预测模型，同时绘制列线图以实现模型的可视化应用，并采用受试者工作特征（

ROC

）曲线和

Hosmer

Lemeshow

拟合优度检验、决策曲线分析（

DCA

）评估模型的预测效能、校准度及临床实用性。

结果

多因素

Logistic

回归分析显示，术前甲状旁腺激素（PTH）、术后第1天PTH水平较低均为甲状腺肿瘤患者ETGUA治疗后发生并发症的独立危险因素（

0.05）。基于上述因素构建

Logistic

回归风险预测模型[Logit（

）=3.835-0.044×术前PTH-0.055×术后第1天PTH

]

，并绘制列线图；

ROC

曲线分析显示该模型预测并发症发生的曲线下面积（

AUC

）为0.779（95%

：0.687~0.870），敏感度为71.00%，特异度为81.00%，约登指数为0.520；

Hosmer

Lemeshow

拟合优度检验显示模型预测值与实际值拟合良好（

=4.347，自由度=8，

=0.825）；

DCA

显示在阈值概率0.05~0.40范围内，模型净获益较高。

结论

术前PTH、术后第1天PTH水平较低是甲状腺肿瘤患者经ETGUA治疗后并发症发生的影响因素，二者联合构建的风险预测模型具有较高的预测价值，可为临床防治提供一定参考。

Abstract

Objective

To investigate the influencing factors for postoperative complications following endoscopic thyroidectomy through gasless unilateral axillary approach （ETGUA） and construct a corresponding risk prediction model.

Methods

A retrospective analysis was conducted on the clinical data of 220 patients with thyroid tumors who underwent ETGUA in our hospital from January 2023 to March 2025. The patients were divided into the non-complication group （

=189） and the complication group （

=31） based on whether postoperative complications occurred. The univariate analysis and multivariate

Logistic

regression analysis were conducted to identify the influencing factors for complications after ETGUA treatment in patients with thyroid tumors， and then a

Logistic

regression prediction model was constructed and visualized with a nomogram. The predictive efficacy，calibration degree and clinical practicability of the model were evaluated using the

receiver operating characteristic

（

ROC

） curve，

Hosmer

Lemeshow

goodness-of-fit test，and

decision curve analysis

（

DCA

）.

Results

The results of multivariate

Logistic

regression analysis showed that low levels of preoperative parathyroid hormone （PTH） and PTH on the first day after surgery were both independent risk factors for complications after ETGUA in patients with thyroid tumors （

0.05）. Based on these factors，a

Logistic

regression risk prediction model was constructed ［Logit（

）=3.835-0.044×preoperative PTH-0.055×PTH on the first day after surgery］，and a nomogram was drawn. The

ROC

curve analysis showed that the

area under the curve

（

AUC

） of this model for predicting complications was 0.779 （95%

：0.687 to 0.870），with a sensitivity of 71.00%，a specificity of 81.00%，and a

Youden

index of 0.520. The

Hosmer

Lemeshow

goodness-of-fit test showed that the predicted probability of the model was in good agreement with the actual probability （

=4.347，degrees of freedom=8，

=0.825）.

DCA

showed that the net benefit of the model was significantly higher within the threshold probability range of 0.05 to 0.40.

Conclusion

Lower preoperative PTH and PTH on the first day after surgery are influencing factors for postoperative complications in thyroid tumors patients treated with ETGUA. The risk prediction model constructed based on the two factors has a relatively high predictive value， which can provide certain references for clinical prevention and treatment.

关键词

Keywords

references

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