内镜甲状腺切除术150例

Endoscopic thyroidectomy with 150 cases

目的 探讨内镜甲状腺切除术的方法与优缺点。方法 采用胸部乳晕入路行内镜甲状腺切除术 15 0例 ,其中甲状腺腺瘤 4 1例、结节性甲状腺肿 6 4例、原发性甲状腺机能亢进 4 0例、甲状腺癌 5例。手术时间 80 (5 0～ 2 70 )min ,行甲状腺肿瘤切除术 32例 ,甲状腺单叶大部分切除 5 4例 ,甲状腺双叶大部分切除 19例 ,甲状腺功能亢进行甲状腺双叶次全切除 37例 ,甲状腺癌行甲状腺单叶并峡部全切除 2例。结果 成功完成手术 14 4例。无神经或甲状旁腺损伤等严重并发症。术后住院时间 4 (3～ 7)d ,术后随访 1～ 13个月 ,无复发 ,患者均对手术的美容效果满意。中转开放手术 6例。结论 内镜甲状腺手术是一种安全、理想的手术方法 ,微小切口选择在身体的隐蔽位置 。

Objective To discuss the method ,the advantages and disadvantages of endoscopic thyroidectomy. Methods Endoscopic thyroidectomy via areola of breasts approach was performed in 150 patients, including 41 cases of thyroid adenoma, 64 cases of nodular goiter, 40 cases of Graves' disease, and 5 cases of thyroid carcinoma. Results The endoscopic thyroidectomy was successfully carried out in 144 cases, including tumor dissection in 32 cases, one lobe partial thyroidectomy in 54 cases, two lobe partial thyroidectomy in 19 cases, subtotal thyroidectomy in 37 cases of Graves' disease, and radical thyroidectomy in 2 cases of thyroid carcinoma. The operative time length ranged from 50 to 270 min(mean 80 min). There were no complications such as damage to recurrent laryngeal nerve or parathyroid glands. Postoperative hospital stay ranged from 3 to 7 days( mean 4 days). The post operative following up for 1～13 months indicated that all the patients were satisfied with the cosmetic results and the same curative effects as conventional surgery were obtained. However, the operations were converted into open surgery in 6 cases. Conclusions Endoscopic thyroidectomy is a safe and effective method of thyroid surgery. Since all the minimal incisions are on concealed parts of the body, the obvious cosmetic effect of this method is guaranteed.