一种新的甲状腺手术入路:经颏下入路单孔免充气腔镜甲状腺切除术

A New Approach to Thyroid Surgery: Submental Approach, Single-Hole, Non-Inflatable for Endoscopic Thyroidectomy

目的:介绍一种采用新入路的腔镜甲状腺手术——“经颏下单孔免充气腔镜甲状腺切除术”,初步探讨该手术方式的可行性及安全性。方法:回顾分析我科2020年6月~2021年7月期间,完成“经颏下单孔免充气腔镜甲状腺切除术”的4例甲状腺乳头状癌患者资料,分析患者一般情况、术后病理、术后并发症等。结果:4例患者术后常规病理诊断均为甲状腺微小乳头状癌,手术方式均为单侧甲状腺癌根治术(单侧甲状腺腺叶 + 峡部切除 + 患侧中央区淋巴结清扫术)。手术平均时间2.1 h,平均住院时间6.75 d;术后并发症:术后无声音嘶哑,无低钙性手足麻木等;4例患者均对切口满意。结论:“经颏下入路单孔免充气腔镜甲状腺切除”具有较好的安全行和可行性,该手术入路可作为腔镜甲状腺切除术的可选择的入路之一。

Objective: To introduce a new approach of endoscopic thyroidectomy—“submental single hole suspended endoscopic thyroidectomy” (SSS-Miccoli), and to discuss its feasibility and safety. Methods: The data of 4 patients with papillary thyroid carcinoma who underwent the surgery in our department from June 2020 to July 2021 were retrospectively analyzed, and the general conditions, postoperative pathology, postoperative complications were analyzed. Results: All patients underwent unilateral radical thyroidectomy (unilateral thyroidectomy + isthmus resection + central lymph node dissection). The mean operation time was 2.3 h and the mean hospital stay was 6.75 d. After the surgery, there was no numbness in the lower chin area, no hoarseness, no hypocalcium numbness of hands and feet and other complications. All 4 patients were satisfied with the incision location. The pathological diagnosis of all patients was micropapillary thyroid carcinoma. Conclusion: The submental approach is safe and feasible for endoscopic thyroidectomy with single hole without inflating. This approach can be used as an alternative approach for endoscopic thyroidectomy.