经胸骨前路径腔镜甲状腺切除术49例体会

Endoscopic thyroidectomy via anterior chest wall approach:report of 49 cases

目的探讨经胸骨前路径腔镜甲状腺切除术的可行性、美容性及安全性。方法经胸骨前路径行腔镜甲状腺切除术49例,其中甲状腺瘤20例,结节性甲状腺肿16例,原发性甲状腺机能亢进13例。行甲状腺瘤摘除术19例,单侧甲状腺次全切除17例,双侧甲状腺次全切除13例。结果手术过程顺利,手术时间90～150min,术中出血20～50ml,术后2～4天拔除引流管,术后8天拆线,无气管、甲状旁腺损伤,无术后出血及伤口感染等并发症,1例发生暂时性声嘶,术后1个月自行恢复。住院时间3～10天,术后随访3～24个月,无复发病例,美容效果满意。结论腔镜甲状腺手术安全、有效、可行,并且手术适应范围广,能达到较好的微创治疗效果和美容效果。

Objective To study feasibility,cosmetology and security of endoscopic thyroidectomy via anterior chest wall approach. Methods Endoscopic thyroidectomy via anterior chest wall approach of 49 cases.20 cases of thyroid tumor,16 cases of nodular goiter,13 cases of primary hyperthyroidism.19 cases were performed thyroid adenoma resection,17 cases were performed subtotal thyroid lobectomy,13 cases were performed bilateral subtotal thyroid. Results Operations were completed successfully in 49 patients. The operation time was 90-150 minutes, the hospital stay was 3-10 days,the operation bleeding was 20-50ml, 2-4 days after removal of drainage tubes, eight days after suture removal, no trachea, parathyroid hair damage, no postoperative bleeding and complications such as wound infection. One patient with nodular goiter developed transient hoarseness after the operation, no other severe complications involving the trachea and parathyroid occurred, no recurrence cases with 3-24 months follow-up. Conclusion Endoscopic thyroidectomy is safe,effective and feasible.It can attain better tiny wound effect and excellent cosmetic benefits.