内镜辅助小切口甲状腺切除术(最初30例经验总结)

Minimally invasive video assisted thyroidectomy:experience from the initial 30 cases

目的:探讨内镜辅助小切口甲状腺切除术的可行性和安全性。方法:回顾分析2010年8月至2011年1月为30例患者行内镜辅助小切口甲状腺切除术的临床资料。超声示最大结节直径6～36 mm,平均19.8 mm。结果:25例手术获得成功,5例中转传统手术,手术方式包括单侧腺叶、双侧腺叶甚至中央组淋巴结清扫术。切口长度1.7～2.6 cm,平均2.23 cm;手术时间70～175 min,平均110.33 min。25例患者术后疼痛轻,美容效果好,均痊愈出院,无声音嘶哑及手足麻木等并发症发生。结论:即使在学习曲线期间,只要选择好病例,内镜辅助小切口甲状腺手术也是安全、可行的,是微创与美容技术在甲状腺外科领域的最佳结合与体现。

Objective： To explore the feasibility and safety of minimally invasive video assisted thyroidectomy（MIVAT）. Methods：The retrospective analysis was made on the clinical data of initial 30 cases of MIVAT performed in Qilu Hospital of Shandong University from Aug.2010 to Jan.2011.The nodular size on ultrasound was between 6 mm to 36 mm（mean 19.8 mm）. Results：Five cases were converted to traditional operations,and 25 patients successfully underwent MIVAT.The procedure included unilateral lobe excision,bilateral lobes excision and dissection of central group of lymph nodes.The incision size was from 1.7 to 2.6 cm（mean 2.23 cm） for different thyroid sizes.The mean operative time was 110.33 min（range from 70 min to 175 min）.Excellent results were obtained in all cases about patients comfort,postoperative pain,and attractive cosmetic results 3 months after operation.No complications such as hoarseness or deadlimb occurred. Conclusions：MIVAT can be safely and effectively performed by surgeons who are not proficient in laparoscopic technique previously.Even during the learning curve,MIVAT is an acceptable alternative to conventional surgery in highly selected patients.