腔镜辅助下小切口甲状腺切除术——119例病例回顾

Minimally invasive video- assisted thyroidectomy: A report of 119 cases

目的:探讨腔镜辅助下小切口甲状腺切除术(minimally invasive video-assisted thyroidectomy,MIVAT)的可行性和临床应用。方法:自2012年1月-2013年12月,回顾性分析119例行MIVAT病人的临床资料,总结临床效果及并发症情况。结果:119例均手术成功,其中甲状腺单叶切除62人,全切除57人,平均手术时间(98.5±26.7)min vs(126.7±37.1)min。术后病理结果:结节性甲状腺肿42人,腺瘤性甲状腺肿32人,腺瘤9人,乳头状癌26人,滤泡状癌6人,桥本氏病4人。暂时性和永久性的喉返神经损伤分别为4人和2人。暂时性的低钙血症单叶和全切术分别为2人和7人。无永久性低钙血症发生。美容效果在术后1月及6月评价为好或非常好的分别为101人(84%)和112人(94%)。4人术后伤口感染。结论:MIVAT是一种安全可行的术式,在美容效果及术后恢复方面有其独特的优势,并发症未增多。

Objective：To explore the feasibility and clinical application of minimal invasive video-assisted thy-roidectomy（ MIVAT）. Methods：A retrospective study of 119 consecutive patients who underwent MIVAT was con-ducted,to summarize the clinical effects and complications. Results：MIVAT was successfully performed in all 119 pa-tients. 62 patients underwent lobectomy and 57 patients underwent total thyroidectomy,the mean operation time was （98. 5 ± 26. 7）min vs（126. 7 ± 37. 1）min respectively. In the final pathology report,there were 42 nodular goiter,32 adenomatous goiter,9 follicular adenoma,26 papillary thyroid cancers,6 follicular cancers and 4 Hashimoto disease. Transient versus permanent recurrent laryngeal nerve injury was 4 and 2 respectively. Postoperative transient hypocal-cemia was diagnosed in 2 and 7 patients following thyroid lobectomy versus total thyroidectomy,respectively. No per-manent hypocalcemia was found. Cosmetic effects were assessed after 1 and 6 months of follow-up as very good or excellent by 101（84%）and 112（94%）patients,respectively. Conclusion：MIVAT was a safe and feasible opera-tion,with good cometic effects and no more complications.