经口腔前庭腔镜甲状腺手术16例

Preliminary experience with transoral endoscopic thyroidectomy vestibular approach:a report of 16 cases in a single center

目的:探讨经口腔前庭腔镜甲状腺手术的经验及术后并发症。方法:回顾性分析2017年2月—2018年3月16例在青岛大学附属烟台毓璜顶医院甲状腺外科接受经口腔前庭腔镜甲状腺手术的病例资料,甲状腺乳头状癌15例,甲状腺腺瘤1例。总结患者的手术方式、建腔经验、手术时间、并发症及随访情况。结果:12例行单侧腺叶+中央区淋巴结清扫,平均时间134.3±36.1 min;3例行全切+中央区淋巴结清扫,平均时间243.3±32.5 min;平均淋巴结清扫数目10.9±4.2;淋巴结转移率33.3%(5/15),平均淋巴结转移数目2.4±1.7。暂时性甲状旁腺功能减退2例,暂时性颏神经损伤1例,嘴角撕裂伤2例,颌下皮肤肿痛硬结1例。结论:经口腔前庭甲状腺手术美容效果极佳。良好的建腔技术能够给患者带来更佳的术后舒适度,更低的并发症发现率。

Objective:To summarize the experience and complications of Transoral endoscopic thyroid surgery vestibular approach(TOETVA).Methods:This study retrospectively reviewed all TOETVA operations performed from February,2014 to March,2016 at Qingdao University Affiliated Yantai Yuhuangding Hospital,Experience of creating working space,types of operation,operation time,complications and results of follow-up were analysed.Results:Total 16 cases were underwent TOETVA.no convertion to conventional operation was ocurred.one cases was performed for follicular adenoma.Twelve cases with PTC underwent hemithyroidectomy plus isthmectomy and central neck dissection(CND),with the mean operation time of(134.3±36.1)minutes;and three cases were performed total thyroidectomy and CND,and(134.3±36.1)minutes for total thyroidectomy with CND.The mean number of lymph node yields was 10.9±4.2,and the lymph node metastasis rate was 33.3%(5/15).Regarding postoperative complications,transient hypoparathyroidism occurred in 2 cases.One case suffered obvious swollen and rigid skin under jaw.Paresthesia of the lower lip and the chin due to mental nerve injury was observed in One case.Two cases suffered tearing of the oral commissure.No transient or permanent hoarseness and no permanent hypoealcemia was registered.Conclusion:TOETVA is a safe and feasible for selected patients who desire to optimize aesthetics.And continuous improvement for creating working space would give more comfortable experience for those patient.