全内镜下甲状腺切除术治疗分化型甲状腺癌25例

Endoscopic thyroidectomy for differentiated thyroid carcinoma： report of 25 cases

目的 总结全内镜下甲状腺切除术治疗分化型甲状腺癌的经验并评估其治疗效果.方法 回顾性分析自2004年11月至2009年7月行乳晕腋窝入路全内镜下甲状腺癌手术25例患者的临床资料. 结果全部25例患者均在全内镜下成功实施甲状腺根治性手术,11例行患侧腺叶全切,14例行患侧腺叶全切加峡部及对侧腺叶大部分切除;7例术中清扫淋巴结.术后病理诊断均证实为分化型甲状腺癌（乳头状癌23例,滤泡状癌2例）,中位随访时间28.0月（5～58月）,无手术并发症,无复发病例,全部患者对美容效果满意.结论 内镜下甲状腺切除手术治疗分化型甲状腺癌是一种兼顾安全性,可行性及美容性的方法.

Objective To summarize the experience of totally endoscopic thyroidectomy （TET） in treating differentiated thyroid carcinoma and to evaluate its feasibility, safety and the therapeutic result.Methods The clinical data of 25 cases of thyroid carcinoma treated with TET via the areola of breast or by axillary approach from November 2004 to July 2009 in our hospital were retrospectively analyzed.Result TET procedures were successfully performed in all 25 cases. Postoperative pathology confirmed that 23 cases were of papillary cancer and the other 2 were follicle cancer. Lobectomy and subtotal thyroidectomy were performed in 11and 14 cases respectively. In 7 cases additional lymph node dissection was performed.All the cases were followed-up, ranging from 5 to 58 months, with a median of 28 months. No recurrence was found during this period. There was no morbidity nor major complications and patients were all satisfied with the cosmetic effect. Conclusion Totally endoscopic thyroidectomy （TET） is curative, safe and cosmetic therapy for differentiated thyroid carcinoma.