完全乳晕入路与胸乳入路腔镜甲状腺切除术的临床比较

Comparison between endoscopic thyroidectomy by completely areola approach and breast approach

目的比较经完全乳晕入路与胸乳入路腔镜甲状腺切除术的的临床效果。方法将364例适合行双侧腔镜甲状腺次全切除或近全切除术的患者分为完全乳晕组(274例)与胸乳入路组(90例),分别行经完全乳晕入路与经胸乳入路腔镜甲状腺切除手术,比较其临床治疗效果。结果两组364例均成功完成腔镜甲状腺切除术,无中转。完全乳晕组手术时间较胸乳组延长但术后患者对手术的美容效果满意度则优于胸乳组,差异有显著性(P<0.01);术中出血量、伤口引流管量、术后止痛药使用、局部麻木感和术后住院时间比较两组间差异无显著性;两组均无大出血及喉返神经等严重并发症发生。结论完全乳晕入路较经胸乳入路腔镜甲状腺切除术,手术时间稍延长、但美容效果更好,其他临床特点类似。

[ Objective ] To compare the clinical efficacy of endoscopic thyroidectomy by completely areola approach and breast approach. [Methods ] 364 admitted patients with both side nodular goiter or hyperthyroidism were underwent endoscopic subtotal or nearly total thyroidectomy into two groups. Group 1 （n=274） patients underwent en- doscopic thyroidectomy by completely areola approach. Group 2 （n=90） patients underwent endoscopic thyroidectomy by breast approach. Clinical features were observed and analyzed statistically. [ Results ] All 364 cases were suc- cessfully done without conversion to conventional procedure. Compared with endoscopic thyroidectomy by breast ap- proach, in completely areola approach group the median operating time was longer while the cosmetic results was superior （P 〈0.01）. However, the median blood loss, the wound drainage, the postoperative consumption of analgesics, postoperative wound numbness, the length of postoperative hospital stay were equivalent in both groups. There were no intraoperative or postoperative large hemorrhage, no injury to the recurrent laryngeal nerve or any other serious postoperative complications in either group. [ Conclusions ] Compared with endoscopic thyroidectomy by breast approach,endoscopic thyroidectomy by completely areola approach has better satisfactory cosmetic results, but the median operating time is longer and the other the clinical efficacy is similar.