经乳晕径路腔镜甲状腺切除术临床分析

Clinical analysis of endoscopic thyroidectomy via breasts areola approach

目的探讨经乳晕径路腔镜甲状腺切除术的安全性和可行性。方法采用经乳晕入路腔镜甲状腺切除术89例。术前诊断甲状腺腺瘤49例,结节性甲状腺肿24例,桥本甲状腺炎6例,甲状腺功能亢进7例,甲状腺癌3例。行甲状腺肿块切除33例,甲状腺次全切除38例,甲状腺腺叶切除18例,行颈中央区淋巴结清扫9例。结果腔镜下成功完成手术85例,4例中转开放手术,术后2～4d拔除引流管。平均手术时间(83±36.7)min,平均术中出血量(42±21.9)mL,平均术后住院(3.5±1.1)d。术后并发症3例,其中2例喉返神经损伤,1例低血钙。术后随访4～47个月,4例复发。结论经乳晕入路腔镜甲状腺手术安全,可行,美容效果满意,对合适的病例可以常规应用。

[Objective] To assess the feasibility and security of endoscopic thyroidectomy via breast areola approach (ETBAA). [Methods] Endoscopic thyroidectomy via areola of breasts approach was performed in 89 cases. Preoperative diagnosis included 49 cases of thyroid adenoma. 24 cases of nodular goiter, 6 cases of Hashimoto′s thyroiditis, 7 cases of Graves′ disease and 3 cases of thyroid cancer. Tumor enucleation was performed in 33 cases, subtotal thyroidectomy in 38 cases, lobectomy in 18 cases and central neck l...