经口前庭入路腔镜甲状腺切除术30例分析

Totally transoral video-assisted thyroidectomy： report of 30 cases

目的探讨经口人路腔镜甲状腺切除术的有效性和安全性。方法对2014年1月至2016年12月上海交通大学附属第六人民医院普外科收治的30例行经口入路甲状腺切除术的患者进行回顾性分析。记录手术时间、术中出血量、住院时间、美容评分、术后并发症等情况。结果患者无颈部切口，具有极佳美容效果，平均手术时间（97．3±13．4）min；术中出血量24．0（12．3～28．3）ml；平均住院天数（2．0±0．5）d，美容评分为（8．2±0．3）分。术后无声音嘶哑、饮水呛咳、出血、抽搐、甲状旁腺损伤等并发症，2例出现颈前区肿胀，2例暂时性下颌部麻木，1例暂时性低钙血症均给予相应对症处理后缓解，术后随访1～35个月，均无明显不适。结论经口人路甲状腺切术创伤小、恢复快、并发症少且术后美容效果好，是一种安全、有效、可行的术式。

Objective To discuss the feasibility of totally transoral video-assisted thyroidectomy （TO- VAT）. Methods Data of 30 hyperthyroidism patients treated with TOVAT from Jan. 2014 to Dec. 2016 were retrospectively analyzed. Index such as operative time, intraoperative blood loss, hospital stay, complication were recorded. Results No neck scar was found, and patients were satisfied with the cosmetic effects. The average surgical time was （97.3±13.4） min, blood loss 24.0（12.3～28.3）ml, hospital stay （2.0±0.5）d, cosmetic score 8.2～0.3. No hoarse voice, drinking cough, bleeding, convulsion, or parathyroid injury happened. Two patients had swelling in the anterior cervicaarea,2 patients showed lower jaw numbness and 1 patient showed temporary hy- poparathyroidism. During the follow up of 1 to 35 months, all were subjected to symptomatic management and recovered. Conclusion TOVAT is a safe and effective technique with the advantages of minor iniury, quicker recovery, fewer complications and good cosmetic effect.