甲状腺结节的腔镜手术治疗体会

Experience of endoscopic thyroidectomy in treatment of thyroid nodule

目的 探讨腔镜下甲状腺切除术治疗经验体会。方法 选择2013年6月-2015年6月我院行甲状腺手术的患者46例,根据手术方法 分为两组,观察组23例采用胸乳入路腔镜手术治疗,对照组23例采用传统开放性手术治疗。术后对疗效、手术时间、出血量、美观度等数据进行组间比较。结果 观察组患者均获得成功,患者无因不良事件中转行开放性手术,术后良性病变随访3-24个月,观察组1例结节性甲状腺肿复发,1例甲状乳头状腺癌肺部转移。对照组3例结节性甲状腺肿复发。观察组患者的术中出血量、美容疗效优于对照组,差异有统计学意义（P〈0.05）。但在手术时间、术后引流量、术后引流时间、术后住院时间以及并发症等方面两组比较,差异无统计学意义（P〉0.05）。结论 胸乳入路腔镜微创手术治疗甲状腺良性肿瘤具有创伤小、疗效好、安全性高美观度高等优势,有临床推广应用价值。

Objective To summarize the experience of totally endoscopic radical thyroidectomy.Methods A total of 46 patients who underwent thyroidectomy operation in our hospital from June 2013 to June 2015 were enrolled as the research objects.According to the different treatment methods,they were divided into observation group with 23 patients underwent endoscopic surgery via chest-breast approach,and control group with 23 patients received conventional open surgery.The efficacy,operation duration,blood loss and beauty etc were compared between the two groups.Results Observation group patients were all successful,without adverse events in patients with turned to open surgery,benign lesions were followed up for 3 to 24 months postoperative,in the observation group,there were 1 case of recurrence of nodular goiter,1 case of thyroid papillary adenocarcinoma of lung metastasis,while there were 3 cases of recurrent nodular goiter in the control group.Effect of intraoperative and blood loss in observation group was better than that of control group,the difference was statistically significant（P〈0.05）,but there was no statistically significant difference in the operative time,postoperative drainage volume,time of postoperative drainage after surgery,hospital stay and postoperative complications between the two groups（P〉0.05）.Conclusion Endoscopic surgery via chest-breast approach in treating benign thyroid tumors has the advantages of less trauma,good effect,high safety and scar aesthetics,therefore it is worthy of promotion.