乳晕入路腔镜甲状腺切除术与传统甲状腺切除术的术后并发症对比研究

Postoperative complications of endoscopic thyroidectomy via breast areola vs conventional open thyroidectomy

目的对比分析乳晕入路腔镜甲状腺切除术与传统甲状腺切除术在术后并发症方面的差异。方法回顾性分析2011年6月至2014年6月475例完成甲状腺手术患者的临床资料，按手术方式的不同分为传统开放组241例，乳晕入路腔镜组234例。对比分析两种术式并发症方面的差异。结果所有手术均顺利完成，无气管损伤、纵隔气肿、术中大出血及心肺脑系统等严重并发症。两组在喉返神经损伤、颈交感神经麻痹综合征、甲状旁腺功能减退、乳糜漏、术后出血、切口感染等并发症之间的差异均无统计学意义（均P〉0．05）；腔镜组皮下瘀斑并发症发生率较高，两组之间差异有统计学意义（P〈0．05）。结论与传统甲状腺切除术相比，乳晕入路腔镜甲状腺切除术不增加术后主要并发症的发生率，且美容优势突出。

Objective To compare postoperative complications between endoscopic thyroidectomy via breast areola approach and open thyroidectomy. Methods From June 2011 to June 2014, 475 patients underwent thyroidectomy. Patients were divided into traditional open group （251 cases） and endoscopic thyroidectomy group （224 cases）. Postoperative complications were recorded and compared. Results All operations were successfully completed. There was no case in endoscopic thyroidectomy group converted to traditional open surgery. There was no serious postoperative complication occurred, including injury to trachea, mediastinal emphysema, intraoperative massive hemorrhage and cardiopulmonary accidents. The difference of postoperative complication between two groups had no statistical significance （ all P 〉 0. 05） as to permanent recurrent laryngeal nerve injury, Horner syndrome, permanent hypoparathyroidism, chyle leakage, postoperative hemorrhage and infection of incision. However, postoperative ecchymosis was more often in endo group （ P 〈 0.05 ）. Conclusions Compared to traditional open thyroidectomy, endoscopic thyroidectomy via breast areola approach has significant cosmetic advantages without increasing the incidence of major postoperative complications.