腔镜治疗12例分化型甲状腺癌

Laparoscopic thyroidectomy in the treatment of 12 patients with well-differentiated thyroid carcinoma

目的探讨腔镜治疗分化型甲状腺癌的可行性和有效性。方法回顾性分析我科行腔镜治疗的12例分化型甲状腺癌。甲状腺组织行全切或一侧腺叶全切除加峡部及对侧次全切除，双侧颈部淋巴结清扫术按中央区颈淋巴结清扫术式进行。12例均接受术后甲状腺素片替代治疗。结果12例无手术死亡，术后并发症2例为声音嘶哑，1例手足麻木，1例暂时性甲状旁腺功能减退。清除淋巴结0～13枚，平均7．6枚／例，1例双侧淋巴结均阳性，5例一侧淋巴结阳性，6例双侧淋巴结均阴性。病理结果均为乳头状癌。12例均获30～62个月（平均50．4个月）随访，均存活，无复发。结论分化型甲状腺癌行腔镜甲状腺切除联合颈部中央区淋巴结清扫术有一定的安全性，在一定程度上能兼顾手术彻底性和颈部的美容效果。

Objective To evaluate the feasibility and efficacy of laparoscopic thyroidectomy in the treatment of thyroid carcinoma. Methods 12 patients with thyrlod carcinoma treated with laparoscopic thyroidectomy from January 2003 to January 2006 in our hospital were analyzed retrospectively. Results All operations were successful and there were no surgical deaths. The postoperative complications included 2 cases of hoarseness, 1 extremity numbness and 1 temporary hypoparathyroidism. The number of dissected lymph nodes was from 0 to 13 with a mean of 7. 6 nodes in each patient. Of the 12 patients, there was one patient with bilateral lymph nodes metastasis, 5 patients unilateral positive lymph nodes and 6 patients no lymph nodes involvement. The pathologic result of all 12 cases was papillary thyroid carcinoma. After 30 to 62 months＇ follow-up （average 50. 4 months） , all patient were still survive and no local recurrence or distance metastasis happened. Conclusion Laparoscopic thyroidectomy in the treatment of early papillary thyroid carcinoma is safe and feasible.