经胸乳径路腔镜甲状腺切除术350例体会

Clinical experinces of endoscopic thyroidectomy via anterior chest wall approach in 350 cases

目的探讨经胸乳径路腔镜甲状腺切除术的方法及其可行性。方法 2008年3月至2011年5月行经胸乳径路腔镜甲状腺切除术350例,回顾性分析350例患者的临床资料。其中甲状腺瘤142例,结节性甲状腺肿180例,原发性甲状腺机能亢进23例,甲状腺乳头状微小癌5例。行甲状腺瘤摘除术16例,单侧甲状腺次全切除130例,双侧甲状腺次全切除134例,单侧甲状腺腺叶切除42例,甲状腺全切除28例。结果手术过程顺利,平均手术时间(72.0±30.4)min,平均术中出血量(45.0±15.8)ml,无中转开放手术,无声嘶或甲状旁腺损伤等并发症发生,平均住院时间(7.0±4.5)d,术后随访3～30个月,无复发病例。结论经胸乳径路腔镜甲状腺切除术是安全可行的,且具有良好的美容效果。

Objective To explore the operative technique and feasibility of endoscopic thyroidectomy via anterior chest wall approach.Methods From March 2008 to May 2011,350 cases with thyroid diseases received via anterior chest wall approach endoscopic thyroidectomy were analyzed retrospectively.One hundred and forty-two cases of thyroid tumor,180 cases of nodulargoiter,23 cases of primary hyperthyroidism,5 cases of papillary microcarcinoma.Sixteen cases were performed adenoma resection,130 cases were performed unilateral subtotal lobectomy,134 cases were performed bilateral subtotal lobectomy,42 cases were performed unilateral total lobectomy,28 cases were performed total thyroidectomy.Results Operations were successfuly peformed in 350 cases.There was no operative complication,nor recur cases with 3-30 months follow-up.The mean operation time was（72.0 ± 30.4） minutes,the mean operation blooding was（45.0 ± 15.8）ml,the average hospital stay was（7.0 ± 4.5） days.Conclusions Endoscopic thyroidectomy via anterior chest wall approach is safe,feasible and has a good cosmetic effect.