经胸入路的腔镜下甲状腺切除术的临床应用

Clinical Application of Endoscopic Thyroidectomy via Anterior Chest

探讨腔镜下行甲状腺切除术的可行性及临床应用价值。对25例甲状腺不同疾病患者(15例甲状腺腺瘤、6例结节性甲状腺肿、2例原发性甲状腺功能亢进和2例甲状腺癌)采用经胸入路腔镜下行相应的甲状腺手术,并对全组病例随访1年余。结果为腔镜下完成手术24例,因局部出血较多造成视野模糊故中转1例。手术平均用时90min,术中出血5～40mL,术后平均住院天数为5d。无神经、甲状旁腺损伤等并发症发生,术后随访患者美容效果满意。由此可得结论:腔镜下进行甲状腺手术与其他腔镜手术相比,微创优势虽不明显,但仍是安全可行的,颈部无疤痕,具有很好的美容效果,尤其适合于中青年女性患者。

To explore its possibility and significance, the thyroidectomy under laparoscopy, was performed for 15 eases with thyroid neoplasms, partial thyroidectomy for 6 cases with nodular goiter, and subtotal thyroidectomy for 2 cases with primary hyperthyroidism. All patients were followed up for 1 year. 24 cases are successful without injury of nerve and parathyroid gland, 1 case is transferred to open operation due to bleeding, which turns out successful. The operation time ranges from 62 to 210 minutes, with an average of 90 minutes. The bleeding in operation is 5 to 40 mL and the post-operational hospitalization takes 5 days. No complication was observed in 1 year＇s follow-up. No recurrence was developed in primary hyperthyroidism cases. It is concluded that the thyroidectomy under laparoscopy is safe with good cosmetic effect.