经胸骨前径路内镜下甲状腺手术20例报告

Endoscopic Thyroidectomy via Anterior Chest Wall Approach (with A Rep ort of 20 Cases)

目的探讨胸骨前径路内镜下甲状腺手术的临床应用和适应证. 方法对20例甲状腺疾病患者行胸骨前径路内镜下甲状腺手术治疗. 结果手术均顺利,其中腺瘤摘除术4例,单侧腺叶次全切除术10例,双侧腺叶次全切除术5例,1例乳头状癌早期病变行患侧全切、对侧次全和峡部切除.平均手术时间124(50～240)min,术后平均住院时间为4(3～6)d.随访1年,未见复发,无手术并发症,颈部无疤痕,治疗和美容效果满意. 结论此术式对治疗甲状腺良性病变是安全、有效、可行的,也可有选择地用于治疗早期甲状腺乳头状癌和Ⅱ度肿大的甲亢病人.

Objective To study the clinical applications a nd indications of endoscopic thyroidectomy via anterior chest wall approach. Method Endoscopic thyroidectomy via anterior chest wall approach was performed in 20 patients. Results Oper ations were successfully performed in 20 cases including 4 cases of adenoma rese ction, 10 cases of subtotal lobectomy, 5 cases of bilateral subtotal lobectomy, and 1 case of early papillary carcinoma who underwent total tumor-bearing lobec tomy, isthmus resection and the contra-lateral subtotal lobectomy. There was no operative complication, nor incision scar in neck resulting in cosmetic effect with 1year follow-up. The mean operation time was 124(50～240) minutes. The average hospital stay was 4(3～6)days. Conclusion Endoscopic thyroidectomy via the anterior chest wall approach is safe, effecti ve and feasible for benign thyroid lesions, which can also be taken into conside ration of the surgical treatment for early stage thyroid papillary carcinoma and grade Ⅱ Grave's disease.