腔镜甲状腺手术术后并发症的临床分析

Clinical analysis of postoperative complications in patients with endoscopic thyroidectomy

目的：探讨腔镜甲状腺手术的疗效及术后并发症情况。方法：回顾分析2010年12月至2013年3月为76例患者行腔镜甲状腺手术的临床资料。结果：74例成功完成腔镜手术,成功率97.4%;2例中转开放手术。手术时间1.4-5.1 h,平均（2.5±0.7）h;病理结果示甲状腺乳头状癌12例,2例伴淋巴结转移,1例隐匿性癌,8例甲状腺腺瘤,余者均为结节性甲状腺肿。36例行双侧切除术,25例行单侧切除术,13例行单纯肿物切除术。术后平均住院（1.55±0.6）d,术后引流量平均（45±5）ml/d。术后随访6个月,无严重并发症发生。结论：腔镜甲状腺手术切口小且隐蔽,具有开放手术无可比拟的美容优势,患者损伤小,术后康复快,并发症少,是安全、有效的术式。但术后胸前区疼痛仍是腔镜甲状腺手术较常见的并发症,因此如何减少胸前游离区的疼痛仍需不断探索。

Objective： To investigate the effect and postoperative complications of endoscopic thyroidectomy. Methods： A retrospective analysis was made on clinical data of 76 patients who underwent endoscopic thyroidectomy from Dec. 2010 to Mar. 2013,the incidence and prevention actions of operative complication were summarized. Results： The endoscopic thyroidectomy was successfully carried out in 74 cases,the success rate was 97. 4%. 2 cases were converted to open surgery. The operative time ranged from 1. 4 h to5. 1 h,the mean was（ 2. 5 ± 0. 7） h,there were 12 cases of thyroid papillary carcinoma,2 cases with lymph node metastasis,1 case of occult carcinoma,8 cases of thyroid adenoma,the rest were nodular goiter. 36 patients underwent bilateral resection,25 patients received unilateral resection,and simple tumor resection was implemented in 13 patients. The average postoperative hospital stay was（ 1. 55 ±0. 6） d,the average daily volume of drainage after operation was（ 45 ± 5） ml,patients were followed up for 6 months. No serious complications occurred. Conclusions： Endoscopic thyroidectomy is a mini-invasive,safe and effective method of thyroid surgery with quick recovery and few complications. The operative incision is small and hidden,it is guaranteed the incomparable cosmetic effect of this method. Postoperative chest pain is a common complication of this procedure,the method to decrease pain at chest separation area still needs further investigation.