腔镜下切除巨大甲状腺病变的手术经验

Experience of endoscopic resection in huge thyroid lesions

目的探讨腔镜下切除巨大甲状腺病变的可行性。方法选择15例甲状腺良性病变患者,病变最大直径10 cm。采用胸乳入路腔镜下切除甲状腺病变的手术方法。结果全组均顺利完成手术,无中转开放手术。术中出血量为5～600(75±20)mL,1例因手术断面出血控制不佳,出血量较多。手术时间为55～180(88±21)min,术后住院天数为3～6(3.8±0.5)d。1例术后一周出现皮下积液,重新放置引流管治愈。无其它并发症。全组患者对手术美容效果均满意。结论腔镜下采用分块切除的方法切除巨大甲状腺病变是可行的,但须选择良性病变。

Objective To investigate the feassbility of endoscopic resection in huge thyroid lesions. Methods Fifteen cases of benign thyroid lesions with 10 cm in maximum diameter underwent surgical treatment. The breast-areola approach was used for endoscopic resection of thyroid. Results All operations were completed successfully. No case conversed to the open surgery. Blood loss ranged from 5 to 600 （75±20） mL. Operative time ranged from 55 to 180 （88±21） min. Postoperative hospital stay ranged from 3 to 6 （3.8±0.5） d. Postoperative subcutaneous hydropsy occurred in one case one week after operation, and it was cured by drainage. All patients were satisfactory in surgical cosmetic results. Conclusions It is feasible to use of endoscopic stepwise resection method for huge thyroid lesions. But the benign lesion is a good choice.