完全内镜全乳晕径路甲状腺手术治疗甲状腺良性肿瘤的临床效果观察

Total endoscopic thyroidectomy via bilateral areolar approach in the treatment of benign thyroid tumor: an observation of clinical effects

目的探讨完全内镜全乳晕径路甲状腺手术治疗甲状腺良性肿瘤的临床效果。方法对桂林市第二人民医院2014-07～2015-05接受完全内镜全乳晕径路甲状腺手术的32例良性肿瘤患者的临床资料进行回顾分析。结果32例均成功完成手术，无中转，手术时间60～180（105±22．5）min，术中出血量10～120（38．5±12．6）ml，手术分离皮瓣的面积（71．6±8．6）cm2。术后第1天引流量（81．5±50．35）ml，VAS疼痛评分0～2分（均未使用止痛药），发生声音嘶哑1例（经保守治疗2周后发音恢复正常）。术后住院时间2～3d，随访2～12个月，无复发，美容效果满意。结论完全内镜全乳晕径路甲状腺手术治疗甲状腺良性肿瘤具有安全、较好的美容效果、疼痛轻、并发症少等优点，具有推广价值。

Objective To explore the clinical effects of total endoscopic thyroidectomy via bilateral areolar approach( BAA) in the treatment of benign thyroid tumor. Methods The clinical data of 32 patients with benign thyroid tumors who underwent endoscopic thyroidectomy via BAA in the Second People' s Hospital of Guiling City from July 2014 to May 2015 were analyzed retrospectively. Results Thirty-two patients successfully underwent endoscopic thyroidectomy. Hoarseness occurred in one patient on the first postoperative day and the patient' s pronunciation returned to normal two weeks after the operation. The mean operation time was( 105 ± 22. 5) min and the mean blood loss was( 38. 5 ± 12. 6) ml. The average area of skin flap was( 71. 6 ± 8. 6) cm2. The mean amount of postoperative drainage on the first postoperative day was( 81. 5 ± 50. 35) ml. The average hospital stay after the opearation was 2 to3 days. The postoperative VAS on the first postoperative day was 0 ~ 2. No relapse was found during the follow-up period between 2 and 12 months. Furthermore,the patients were satisfied with the cosmetic results of the operation.Conclusion This operative method has the advantages of safety,minimal invasion,simple manipulation,less postoperative complications and better cosmetic result.