经腋窝入路单孔内镜甲状腺切除术

Single port laparoscopic thyroidectomy through axillary approach

目的探讨经腋窝入路单孔甲状腺切除术的安全性和可行性。方法 2010年6月-2012年12月完成经腋窝入路单孔内镜甲状腺切除术11例,均为女性,平均年龄35.6岁（17-47）,诊断甲状腺腺瘤2例,甲状腺单发结节8例,其中伴囊性变4例,甲状腺单侧多发结节1例。结节平均直径为3.2 cm（2.0-5.5）。对患者手术方式、手术时间、术中出血量、术后引流量、住院时间及美容满意度等进行记录和分析。结果 11例手术均成功完成,未有中转多孔或开放手术。10例行甲状腺部分切除术,1例行单侧甲状腺大部分切除术。平均手术时间为130.5 min（100-180）,术中平均出血量为19.5 m L（10-30）,术后平均引流量为143.2 m L（25-190）,平均住院时间为5.2 d（4-7）,术后疼痛评分2.6分（2-5）,切口满意度评分4.6分（3-5）。结论在严格选择病例的基础上,腋窝入路单孔甲状腺切除术是安全、可行的。

[ Objective ] To explore the feasibility and sMety of single port laparoscopic thyroidectomy throughaxillary approach. [ Methods ] Single port laparoscopic thyroidectomy through axillary approach was performed be-tween 2010 April to 2012 December. All the cases were female with the average age 35.6 yrs （17-47 yrs）. Amongstthem, 2 cases with adenoma, 8 cases with single nodule, 1 case with multiple nodules in unilateral side. The averagesize of the nodule was 3.2 cm （2.0-5.5 cm）. The procedures, the operating time, the blood loss, the hospital stay andthe satisfaction of cosmesis were recorded and analyzed. [Results] All the cases were accomplished successfullywithout conversion to multiple incision or open surgery. 10 cases underwent partial thyroidectomy, 1 case underwentsubtotal throidectomy in unilateral side. The average operating time was 130.5 min （100-180 min）, the average bloodloss was 19.5 mL （10-30 mL）, the average post-operative drainage was 143.2 mL （25-190 mL） and the average cos-metic score was 4.6 points （3-5 points）. [ Conclusion ] For strictly selected patients, single port laparoscopic thy-roidectomy through axillary approach is safe and effective.