全乳晕入路腔镜下甲状腺手术

Endoscopic thyroidectomy via areola of breasts approach

目的探讨乳晕切口入路腔镜下甲状腺手术的美容效果。方法切口位置均在乳晕边缘，右乳晕3点处切口长12mm置30°腔镜、9点处切口长7mm置抓钳。左乳晕11点处切口长12mm置超声刀，皮下分离制造操作空间，根据病变情况行甲状腺部分切除或大部分切除。结果10例均手术成功，手术时间110—230min，平均140min。出血量3～15ml，平均9ml。术后无严重并发症。10例随访3—5个月，平均3.5月，切口瘢痕不明显，无复发病例。结论全乳晕入路腔镜下甲状腺手术安全、可行，美容效果好。

Objective To investigate the cosmetic results of endoscopic thyroidectomy via areola of breasts approach. Methods The incision was chosen to be along the areolar margin. One 12 mm incision was made at 3 - clock position of the right areolar to introduce a 30° flexible laparoscope. Another 7 mm incision was made at 9 - clock position of the right areolar for a grasping forceps, An additional 12 mm incision for the performance of tdtrasonie scalpel was made at 11 - clock position of the left areolar. Subcutaneous tissues were separated to create enough space for partial or subtotal thyroidectomy according to patient＇ s conditions. Results The surgery was finished successfully in all 10 cases. The operation time ranged 110 - 230 min （mean, 140 rain）. The estimated blood loss ranged 3 - 15 ml （mean, 9 ml）, There were no surgical complications after operation. Follow - up checkups for 3 - 5 months （mean, 3.5 months） in 10 cases showed inconspicuous scars and no recurrence. Conclusions Endoscopic thyroidectomy via areola of breasts approach is a feasible and safe procedure with satisfactory cosmetic results.