加长型Trocar在腔镜甲状腺手术中的应用

Application of extended Trocars in endoscopic thyroidectomy

目的:探讨加长型Trocar在腔镜甲状腺手术中的应用价值。方法:回顾分析2010年3月至2012年6月为200例结节性甲状腺肿患者行腔镜单叶甲状腺切除术的临床资料,将患者分为两组(n=100),术中分别使用加长型Trocar与普通Trocar,对比分析两组患者手术时间、术中出血量、皮下分离面积、切口引流量、术后住院时间及术后并发症。结果:两组手术均获成功。加长Trocar组手术时间短[(66.02±8.86)min vs.(73.32±9.30)min,P=0.000],皮下分离面积小[(56.07±5.53)cm2 vs.(95.06±8.12)cm2,P=0.000],术后引流量少[(71.18±17.45)ml vs.(82.06±23.63)ml,P=0.010],术后并发症少(1 vs.8,P=0.017);其他方面差异无统计学意义。结论:加长型Trocar应用于腔镜甲状腺手术可明显减少皮下分离创面,缩短手术时间,方便术中操作,值得推广应用。

Objective：To investigate the clinical significance of extended Trocars in endoscopic thyroidectomy. Methods：The clinical data of 200 patients who underwent endoscopic thyroidectomy of single lobe with extended Trocars （ n = 100 ） or ordinary Trocars （n = 100） from Mar. 2010 to Jun. 2012 were retrospectively analyzed. All the patients were diagnosed as nodular goiter. The operation time, blood loss during operation, subcutaneous dissected area, drainage volume, postoperative hospital stay and complications were compared and analyzed between the 2 groups. Results：Operations were successfully performed in all cases. Compared to ordinary Trocar group, extended Trocar group got shorter operation time [ （66.02 ±8.86） min vs. （73.32 ± 9.30） min, P = 0.000 ] , smaller subcutaneous dissected area [ （56.07 ± 5.53 ） cm^2 vs. （95.06 ±8.12） cm^2, P = 0. 000 ] ,less postoperative drainage [ （71.18 ± 17.45 ） ml vs. （ 82.06 ± 23.63 ） ml, P = 0. 010 ] and complications （ 1 vs. 8, P = 0. 017 ）. There were not significantly statistical differences in other aspects. Conclusions ： Application of extended Trocars in endoscopic thyroidectomy brings benefits of less subcutaneous damage, shorter operation time and better operation experience. This procedure is worth popularizing in clinical use.