内窥镜下甲状腺手术的临床应用

The clinical application of endoscopic thyroidectomy

目的 探讨经腋窝或胸前入路 ,内窥镜下完成甲状腺疾病手术治疗的可行性。 方法 14例 ,年龄 2 1岁～ 36岁。甲状腺腺瘤 11例 (单侧 9例 ,双侧 2例 ) ,结节性甲状腺肿 3例 (单侧 1例 ,双侧2例 )。于腋窝或胸部切口 ,并建立皮下隧道至甲状腺部 ,内窥镜下应用超声刀切除病灶。 结果 11例采用经腋窝入路、3例采用经胸入路 ,全部镜下完成甲状腺手术。手术时间 1小时 4 5分～ 5小时 35分 ,平均 2小时 15分。术中出血 ,经腋窝入路平均 6 5ml,经胸入路平均 135ml。未出现手术并发症。 结论 内窥镜下甲状腺手术是安全可靠的一种新方法。内窥镜的放大作用和冷光源的照明作用 ,使术野更加清晰 ,超声刀可以处理甲状腺的任何血管。

Objective To explore the feasibitity of endoscopic thyroidectomy through armpit or breast approach. Methods 14 patients aged from 21 to 36 years.There were 11 cases of thyroid adenoma(9 cases of single side and 2 cases of double sides)and 3 cases of nodular goiter (1 case of single side and 2 cases of double sides).The mini-mcision was made at armpit or breast.A percutaneous chennel into thyroid gland was performed and the focus was removed with ultrasonic scalpel wnder endoscopy. Results All cases were operated on under endoscopy,in cluding 11 cases through armpit approach and 3 ones through breast approach.The mean operative time was 135(105～335)min.The average blood loss was 65ml through armpit approach and 135ml through breast approach respectively.There was no operative complications. Conclusions Thyroidectomy under endoscopy is a new secure method.