腔镜与开放甲状腺手术的疗效分析

Efficacy analysis of endoscopic and open thyroid surgery

目的:探讨经胸乳入路行腔镜甲状腺手术的临床价值及手术方法。方法:回顾分析2010年1月至2013年6月为39例患者行腔镜下经胸乳入路甲状腺手术(实验组)的临床资料,并与同期开展的36例开放甲状腺手术(对照组)进行对比分析。结果:两组患者手术时间、术中出血量、切口引流量、颈部瘢痕增生等差异均有统计学意义(P<0.05);两组住院时间、并发症发生率差异无统计学意义(P>0.05)。两组患者均未出现甲亢危象、喉返神经、喉上神经损伤、甲状旁腺损伤等严重并发症。结论:腔镜下经胸乳入路甲状腺手术的操作时间较开放手术长,术中、术后出血较开放手术多,但仍是较安全、有效的术式,且美容效果良好。在患者有美容要求的情况下,有条件的医院可选择性开展。

Objective： To explore the application value and operation method of endoscopic thyroidectomy via a breast approach. Methods： Clinical data of 39 patients who underwent endoscopic thyroidectomy via a breast approach from Jan. 2010 to Jun.2013 were retrospectively analyzed and compared with 36 cases of open thyroidectomy during the same period. Results： There were statistical differences in operation duration,intraoperative blood loss,incision drainage and scar proliferation of neck between two operations（ P 0.05）,and no statistical differences in hospital stay and complication rate（ P 0.05）. No hyperthyroidism crisis,recurrent laryngeal nerve injury,superior laryngeal nerve injury or parathyroid gland injury occurred. Conclusions： Compared with open thyroidectomy,the endoscopic thyroidectomy via a breast approach has a longer operation time,more intraoperative and postoperative blood loss,but it is safe and effective,and has better cosmetic results. When the patient has high cosmetic request,the endoscopic surgery could be chosen in qualified hospitals.