腔镜辅助下经锁骨下单切口行双侧甲状腺手术体会(附18例报告)

Experience of video-assisted bilateral thyroidectomy through helmi-subclavicular approach(Report of 18 cases)

目的探讨腔镜辅助下经锁骨下单切口行双侧甲状腺结节手术切除的可行性和治疗效果。方法 18例双侧甲状腺良性结节,取结节较大侧锁骨下切口入路,切口长约3~4cm,行腔镜辅助下甲状腺部分或全部切除。结果 所有患者均手术顺利,手术时间在60~90min之间,出血量20~50mL,无手术并发症,术后3~4d出院,切口一期愈合。随访1~24个月,无肿瘤复发,无颈部麻木、疼痛、吞咽不适。结论严格掌握指征,腔镜辅助下经锁骨下单切口行双侧甲状腺结节手术切除是安全可行的,术后并发症少,颈部外形美观。

[Objective] To discuss the feasibility and the effect of video-assisted bilateral thyroidectomy through helmi-subclavicular approach incision. [Methods]Video-assited partial or completed bilatera thyroidectomy in 18 cases suffer from thyroid benign nodules, the approach was the helmi-subclavicular incision on the side, of larger nodules, the length of the incision was about 3~4 cm.[Results]The operation was accomplished successfully in all the 18 cases. the operation time was about 45~90 minutes, bleeding volume was about 20~50 mL, no surgical complication occurred, the patients discharged 3~4 days after surgery, and the incision healing. During the follow-up of 1 ~24 months, all the 18 patients had no recurrence, no neck pain and numbness, no swallowing discomfort. [Conclusion]Strictly controlled the operation indications, the video-assisted bilateral thyroidectomy through helmisubclavicular approach incision is safe and feasible, less postoperative complications occurred, and the neck appearance is beautiful.