腔镜辅助下微创甲状腺手术治疗甲状腺腺瘤

Minimally invasive video-assisted thyroidectomy for thyroid adenoma

目的:探讨腔镜辅助下微创手术在甲状腺良性肿瘤治疗中的作用。方法:我院于2003年6月～2007年6月共实施腔镜辅助下颈部小切口无气腔室甲状腺手术128例,总结手术经验和观察其术后恢复情况。结果:所有病例均在腔镜辅助下完成微创手术,其中有5例冰冻切片提示为甲状腺癌,3例微小甲状腺乳头状癌在腔镜辅助下行患侧腺叶次全切除,另2例分别为滤泡状癌和髓样癌术中转开放手术;术后常规切口皮片引流,全部病例顺利恢复,仅1例出现可逆性喉返神经损伤,无永久性甲状旁腺功能低下症。结论:腔镜辅助下微创手术治疗甲状腺良性肿瘤安全可靠,并发症少,相比传统手术,术后疼痛轻、渗出少、恢复快,美容效果好。

Objective：To assess the value of minimally invasive video-assisted thyroidectomy for thyroid adenoma. Methods： From June 2003 to June 2007,128 cases of thyroid tumor consist of 123 cases of adenoma and 5 cases of carcinoma were consecutively performed Miccoli＇s endoscopical thyroidectomy. The surgical skills and the clinical outcomes with respect to pathologic results, duration of operation, postoperative drainage, pain, cosmetic results and complications of endoscopic thyroid surgery via the neck approach were retrospectively summarized. Results： All the patients underwent minimally invasive video-assisted thyroidectomy successfully. Five cases of them indicated indraoperatively carcinoma by frozen section, 3 cases of micro papillary carcinoma underwent subtotal thyroidectomy of the lesion side by video-assisting, other 2 cases indicated follicular carcinoma and medullary thyroid carcinoma respectively underwent conventional total thyroidectomy of the lesion side plus subtotal thyroidectomy of the opposite side. The transient hoarseness occurred in 1 case and recovered well one week later, the other patients recovered successfully without any complications. Conclusion：Minimally invasive video-assisted thyroidectomy for thyroid adenoma is safe and reliable. This procedure offers a shorter incision, less invasion and better cosmetic results as compared with conventional thyroidectomy.