微创内镜甲状腺手术入路设计与创口闭合的美容效果分析

Analysis of cosmetic effects of complete endoscopic thyroidectomy approach design and wound closure

目的探讨完全腔镜下甲状腺良性肿瘤手术的手术人路、创口闭合、临床疗效与美容效果。方法回顾性分析自2012年1月至2013年12月女性甲状腺良性肿瘤手术98例患者资料,其中按照美容原则闭合创口的改良胸乳入路完全腔镜下甲状腺部分切除术患者48例,传统手术患者50例,比较两种术式的近期临床疗效与美容效果。结果两组患者手术均获成功,无严重并发症发生。手术时间、术中出血量、术后引流量差异无统计学意义;切口瘢痕评定及美容满意度腔镜组明显优于对照组,差异具有统计学意义。结论与传统术式比较,采取美容原则闭合创口的完全腔镜下甲状腺部分切除术治疗甲状腺良性肿瘤,安全可行,具有良好的美容效果,值得临床推广应用。

Objective To investigate the wound closure, clinical effect and cosmetic results of complete endoscopic thyroidectomy （TET） in the treatment of thyroid benign tumors. Methods From Jan. 2012 to Dec. 2013, 98 patients with benign thyroid tumors were retrospectively analyzed. Among them, 48 cases underwent complete thoracoseopic partial thoracotomy with cosmetic principle closed wounds （TET group, n = 48 ）. Fifty patients were treated with conventional open thyroidectomy （control group, n = 50 ）. Patients＇ clinical data, opera- tion time, blood loss, drainage volume, Vancouver scar scale （VSS） , occurrence of postoperative complications and cosmetic effect were compared. Results All operations were performed successfully in both groups. No serious postoperative complications occurred. There is no significant difference in operation time, blood loss, or drainage volume. VSS was significantly less in the TET group and the satisfaction rate of the cosmetic effect was significantly higher in the TET group. Conclusion Compared with traditional methods, the use of cosmetic principles to close the wound with complete endoscopic partial thyroidectomy for the treatment of benign thyroid tumors is safe and feasible, with good cosmetic results. This method is worthy of clinical application.