腔镜技术在甲状腺手术中的应用进展

Application Progress of Endoscopic Technique in Thyroid Surgery

外科手术是甲状腺肿瘤的主要治疗方式。传统开放手术的颈部切口不可避免地存留颈部瘢痕,已无法满足患者对美容和微创的需求。随着外科理念的不断更新、外科医生的不断探索和器械设备的不断改进,腔镜甲状腺手术经历了从颈部小切口、经锁骨下、经腋窝、经胸前、经口腔、经耳后、经颏下等入路的演变发展。各种路径存在明显优势的同时,也一定程度上存在相对不足,目前尚无腔镜甲状腺手术入路的标准术式。本文按不同入路的首例报道时间顺序对国内外腔镜甲状腺手术的常用入路做一综述。

Surgery is the main treatment for thyroid tumors.The neck incision of traditional open surgery inevitably leaves neck scar,which can not meet the needs of patients for cosmetic and minimally invasive surgery.With the continuous renewal of surgical concepts,the exploration of surgeons and the improvement of instruments and equipment,endoscopic thyroid surgery has experienced the evolution and development from small incision in the neck,through subclavian,transaxillary,through chest,through oral cavity,through ear,through submental and other approaches.While various approaches have obvious advantages,they also have relative disadvantages to some extent.At present,there is no standard operation method for endoscopic thyroid surgery.In this paper,the common approaches of endoscopic thyroidectomy are reviewed according to the time sequence of the first report of different approaches.