经乳晕单孔入路腔镜甲状腺切除术9例报告

Single port endoscopic thyroidectomy via the breast areola approach:a report of 9 cases

目的:探讨经乳晕入路单孔腔镜甲状腺切除术的可行性及应用价值。方法:回顾分析为9例患者行经乳晕入路单孔腔镜甲状腺切除术的临床资料,包括结节大小、手术时间、术中出血量、术后住院时间、手术并发症、术后病理及随访结果。结果:8例患者顺利完成经乳晕入路单孔腔镜甲状腺切除术,1例因术中冰冻病理提示为微小乳头状癌而中转胸乳入路腔镜甲状腺切除术。结节直径平均1.8 cm,手术时间平均110 min,术中出血量20～40 ml,术后平均住院3 d。术后随访,美容效果满意,无复发、神经、甲状旁腺损伤等并发症发生。结论:经乳晕入路行单孔腔镜甲状腺切除术安全可行,身体裸露部位无疤痕,具有较好的美容效果,尤其适于对美容要求高或瘢痕体质的患者。

Objective： To explore the feasibility and clinical value of single port endoscopic thyroidectomy via the breast areola approach. Methods：The clinical data of 9 patients who underwent single port endoscopic thyroidectomy via the breast areola approach were retrospectively analyzed,including the size of the tumor,operation time,blood loss during the operation,postoperative hospital stay,complications,pathological results,and results of follow-up. Results：Eight operations were successful,1 case was converted to endoscopic thyroidectomy via anterior chest and breast approach for thyroid papillary micro-carcinoma indicated by intra-operative frozen section.The mean size of the thyroid nodule was 1.8 cm,the mean operative time was 110 min,blood loss was 20-40 ml,and the mean postoperative hospital stay was 3 d.During the follow up,all the patients were satisfied with the cosmetic appearance.There were no recurrence,recurrent laryngeal nerve or parathyroid injury occurred. Conclusions：Single port endoscopic thyroidectomy via the breast areola approach is a feasible and safe procedure, its cosmetic appearance is much better than the traditional procedure.It is a good choice especially for the patients who have high cosmetic requirement,and patients with cicatricial diathesis.