经腋下入路施行内镜甲状腺切除术的临床应用研究

A clinical study of endoscopic thyroidectomy via incision under the armpit

目的探讨经腋窝入路 ,内镜下完成甲状腺手术的可行性。方法 32例患者均为甲状腺一侧良性病变 ,其中甲状腺腺瘤 2 9例 (单发 2 4例 ,多发 5例 ) ,单叶结节性甲状腺肿囊性变 3例(单发 2例 ,多发 1例 )。手术采用患侧腋窝切口 ,并建立皮下隧道至甲状腺部位 ,在内镜下应用超声刀切除病灶。结果 32例患者均在镜下完成甲状腺手术。平均手术时间 12 5min。术中出血平均5 5ml。未出现手术并发症。结论内窥镜的放大作用和冷光源的照明使术野更加清晰 ,超声刀可以处理甲状腺的任何血管 ,内镜下甲状腺切除术是安全的。

Objective To evaluate the feasibility of endoscopic thyroidectomy via an incision under the armpit. Methods A skin incision was made under the armpit and a channel was established to thyroid gland and endoscopic thyroidectomy was performed in 32 cases suffering from unilateral thyroid lesion including 24 cases of solitary adenoma, 5 cases of multiple adenoma, 3 cases of cystic goiter. Results The average operative time was 125 min and the average blood loss was 55 ml. There were not any postoperative complications. Conclusion Endoscopic thyroidectomy is a mini-invasive surgery. The operative field was clear and ultrasonic scalpel is capable of dealing with blood vessels during the procedure.