腋乳入路腔镜甲状腺切除手术15例初步临床经验

Preliminary clinical experience of endoscopic thyroidectomy via axillary-breast approach in 15 cases

目的总结和分析腔镜下手术的优缺点,期望为初步开展此类手术的同道提供参考。方法选取自2013年1月至于2014年8月我科完成的腋乳入路腔镜下甲状腺手术15例,均为单侧部分或全部切除,均为甲状腺良性病变,无中转开放手术发生,肿物大小1~5cm,手术时间为69~146min,术中出血为10~50ml。结果 1例患者于术后第3天开始出现声音嘶哑,术后第10天自行消失;2例患者出现术后局部皮下积液并皮肤感觉减退,积液经过穿刺抽吸后1周内消失,感觉减退在术后3周内消失;其他病人恢复顺利。术后随访1~20个月效果良好,无明显疤痕及皮肤皱褶,无复发病例。结论腔镜甲状腺能够获得较好的美容效果及手术疗效,是一种较为安全的手术,具备一定的临床应用前景和市场需求。

Objective To summarize and analyze the advantages and shortcomings of endoscopic thyroidectomy,and provide a reference for the ones who initially start the operation.Methods 15 cases of endoscopic thyroidectomy via axillary-breast approach were chosen in our department from Jan.2013 to Aug.2014.All cases were underwent unilateral partial or total removal,were all benign thyoid tumors,without converted to open conventional thyroidectomy.Tumor sizes were from 1~5cm,the operation time lasted 69~146 minutes,intra-operative bleeding were 10~50ml.Results There were 1 case appeared with loudless for 3 days after the operation,and recovered in 10 days,2cases occurred with local paresthesia and subcutaneous effusion,subcutaneous effusion recovered after a week of aspiration,and paresthesia disappeared no more than 3weeks after the operation.All the other patients recovered smoothly.After following up 1~20months after operation,all cases had good effect,no obvious scars and skin folds,no recurrence.Conclusion Endoscopic thyroidectomy can attain better cosmic appearance than the traditional operation.It is a safe and effective operation with a certain clinical application prospect and market demand.