经胸乳入路腔镜下选择性侧颈区淋巴结清扫20例临床分析

Endoscopic selective lateral neck dissection via a chest-breast approach for papillary thyroid carcinoma: preliminary experience in 20 cases

目的:探索腔镜下选择性侧颈区淋巴结清扫的可行性。方法:对2017-01-2018-05期间收治的20例甲状腺乳头状癌伴侧颈部淋巴结转移患者,采用经胸乳入路甲状腺全切除加中央区淋巴结清扫加选择性侧颈区淋巴结清扫术。结果:20例患者均在腔镜下完成甲状腺全切加同侧中央区淋巴结清扫及选择性侧区淋巴结手术。1例发生淋巴漏,1例短暂性声嘶,4例短暂性甲状旁腺功能减退,1例颈内静脉损伤和1例颈外静脉损伤,余未发生其他严重并发症。结论:经胸乳入路腔镜下行侧颈Ⅱ、Ⅲ、Ⅳ区淋巴结清扫术是可行的,美容性好,患者满意度高,未见严重并发症发生,是一种可行的治疗方式。

Objective: To explore the feasibility of endoscopic selective lateral neck dissection(SLND) via a chest-breast approach. Method: We retrospectively reviewed 20 patients who underwent endoscopic total thyroidectomy along with SLND, between January 2017 and May 2018. Result: All the 20 patients underwent total thyroidectomy, central lymph nodes dissection and selective lateral lymph nodes dissection with endoscopic surgery via chest-breast approach. In this study, lymphatic leakage, transient voice hoarseness, internal jugular vein injury and external jugular vein injury were repectively found in one patient, and 4 patients suffered from transient parathyroid hypofunction, without other serious complications. Conclusion: Endoscopic lymph node dissection including levels Ⅱ, Ⅲ and Ⅳ is feasible. It has good cosmetic effect, and haven’t serious adverse events.