腔镜甲状腺切除术与传统开放切除术的临床比较

Comparative study between endoscopic thyroidectomy and conventional thyroidectomy

目的 比较经胸部途径腔镜甲状腺切除术与传统经颈部开放切除术的临床效果。方法 将 92例适合行甲状腺单侧部分切除的患者分为腔镜组 (5 6例 )与开放组 (36例 ) ,分别行经胸部途径腔镜甲状腺切除术与传统经颈部开放切除术 ,比较其临床治疗效果。结果 腔镜组 5 6例成功完成胸骨前入路腔镜甲状腺切除术 ,无中转。术中出血量腔镜组少于开放组 ,术后患者对手术的美容效果满意度腔镜组优于开放组 ,住院费用腔镜组高于开放组 ,差异有显著性意义 (P <0 .0 1) ;手术时间、伤口引流量、术后止痛药使用、局部麻木感、术后住院时间比较两组间差异无显著性意义 ;两组均无大出血、喉返神经等严重并发症发生。结论 经胸部途径腔镜甲状腺切除术与传统经颈部开放切除术比较 ,美容效果好 ,但有手术费用较高的缺点。

Objective\ To compare the clinical efficacy of endoscopic thyroidectomy by breast approach with conventional open thyroidectomy in patients with nodular goiter.Methods\ 92 patients with one side nodular goiter were divided randomly into two groups. Patients in group 1(n=56) were underwent endoscopic thyroidectomy by breast approach. Patients in group 2(n=36) were underwent conventional open thyroidectomy. The therapeutic efficacy were observed and analyzed.Results\ Endoscopic thyroidectomy by breast approach underwent successfully in 56 cases without conversion to conventional procedure. There was a significant difference in cosmetic result, blood loss and hospital cost between two groups(P<0.01). There was no significant difference in median operating time, post-operative wound drainage, consumption of analgesic and hospital stay between two groups. No intraoperative or postoperative hemorrhage and recurrent laryngeal nerve injury occurred in either group.Conclusions\ Endoscopic thyroidectomy by breast approach has satisfactory cosmetic results but higher hospital cost.