目的:研究经胸壁入路腔镜下甲状腺肿瘤切除术对良性甲状腺肿瘤患者术后疼痛程度及美观效果的影响。方法:选取我院94例良性甲状腺肿瘤患者(2019年1月至2019年10月),随机数字表法分为对照组(n=47)和研究组(n=47)。对照组采用低位小切口甲...目的:研究经胸壁入路腔镜下甲状腺肿瘤切除术对良性甲状腺肿瘤患者术后疼痛程度及美观效果的影响。方法:选取我院94例良性甲状腺肿瘤患者(2019年1月至2019年10月),随机数字表法分为对照组(n=47)和研究组(n=47)。对照组采用低位小切口甲状腺肿瘤切除术治疗,研究组采用经胸壁入路腔镜下甲状腺肿瘤切除术治疗。对比两组手术情况、术后康复情况、并发症发生率及对美观效果满意度。结果:研究组手术时间长于对照组,但术中出血量、术后引流量少于对照组,术后24 h VAS评分低于对照组,住院时间短于对照组(P<0.05);研究组吞咽障碍发生率(4.26%)、声音嘶哑发生率(4.26%)、喉返神经损伤发生率(2.13%)、暂时性甲状旁腺功能减退发生率(4.26%)均低于对照组(P<0.05);研究组对美观效果满意度高于对照组(P<0.05)。结论:采用经胸壁入路腔镜下甲状腺肿瘤切除术治疗良性甲状腺肿瘤的操作时间较长,但能显著减轻术中损伤,降低术后疼痛程度,缩短术后康复进程,且术后并发症发生率低,患者对美观效果满意度高,具有较高临床价值。展开更多
Objective: To retrospectively evaluate the feasibility and clinical value of endoscopic thyroidectomy through anterior chest wall. Methods: From December 2002 to May 2003, 28 patients with an average of age of 28 year...Objective: To retrospectively evaluate the feasibility and clinical value of endoscopic thyroidectomy through anterior chest wall. Methods: From December 2002 to May 2003, 28 patients with an average of age of 28 years old (rangeing from 20 to 45) were performed endoscopic thyroidectomy through anterior chest wall. The subcutaneous space in the anterior chest wall and the subplatysmal space in the neck were bluntly dissected through a 10-mm incision between the nipples, and CO 2 was insufflated at 6-8 mmHg to create the operative space. Three trocars were inserted in the mammary regions; and dissection of the thyroid, division of the thyroid vessels and parenchyma were performed endoscopically using an ultrasonically activated scalpel. The recurrent laryngeal nerve, the superior laryngeal nerve, and the parathyroid glands were preserved properly. Results: There were 3 mass resections, 17 subtotal lobectomies, 2 total lobectomies, 6 subtotal lobectomies plus contralateral mass resections. The mean operative time was (87.1±26.0) min; the mean blood loss during operation was (47.9±19.6) ml; and the mean postoperative hospital stay was (3.4±0.7) d. The drainage tubes were pulled out at 36-60 h postoperatively. There were no conversions to open surgery or complications. No scars can be found in the neck, and the patients were satisfied with the postoperative appearance. Conclusion: Endoscopic thyroidectomy through anterior chest wall combined with low-pressure subcutaneous CO 2 insufflation is a feasible and safe procedure. It can bring satisfactory cosmetic results. It is believed that endoscopic thyroidectomy by such approach will find a role in the future.展开更多
文摘目的:研究经胸壁入路腔镜下甲状腺肿瘤切除术对良性甲状腺肿瘤患者术后疼痛程度及美观效果的影响。方法:选取我院94例良性甲状腺肿瘤患者(2019年1月至2019年10月),随机数字表法分为对照组(n=47)和研究组(n=47)。对照组采用低位小切口甲状腺肿瘤切除术治疗,研究组采用经胸壁入路腔镜下甲状腺肿瘤切除术治疗。对比两组手术情况、术后康复情况、并发症发生率及对美观效果满意度。结果:研究组手术时间长于对照组,但术中出血量、术后引流量少于对照组,术后24 h VAS评分低于对照组,住院时间短于对照组(P<0.05);研究组吞咽障碍发生率(4.26%)、声音嘶哑发生率(4.26%)、喉返神经损伤发生率(2.13%)、暂时性甲状旁腺功能减退发生率(4.26%)均低于对照组(P<0.05);研究组对美观效果满意度高于对照组(P<0.05)。结论:采用经胸壁入路腔镜下甲状腺肿瘤切除术治疗良性甲状腺肿瘤的操作时间较长,但能显著减轻术中损伤,降低术后疼痛程度,缩短术后康复进程,且术后并发症发生率低,患者对美观效果满意度高,具有较高临床价值。
文摘Objective: To retrospectively evaluate the feasibility and clinical value of endoscopic thyroidectomy through anterior chest wall. Methods: From December 2002 to May 2003, 28 patients with an average of age of 28 years old (rangeing from 20 to 45) were performed endoscopic thyroidectomy through anterior chest wall. The subcutaneous space in the anterior chest wall and the subplatysmal space in the neck were bluntly dissected through a 10-mm incision between the nipples, and CO 2 was insufflated at 6-8 mmHg to create the operative space. Three trocars were inserted in the mammary regions; and dissection of the thyroid, division of the thyroid vessels and parenchyma were performed endoscopically using an ultrasonically activated scalpel. The recurrent laryngeal nerve, the superior laryngeal nerve, and the parathyroid glands were preserved properly. Results: There were 3 mass resections, 17 subtotal lobectomies, 2 total lobectomies, 6 subtotal lobectomies plus contralateral mass resections. The mean operative time was (87.1±26.0) min; the mean blood loss during operation was (47.9±19.6) ml; and the mean postoperative hospital stay was (3.4±0.7) d. The drainage tubes were pulled out at 36-60 h postoperatively. There were no conversions to open surgery or complications. No scars can be found in the neck, and the patients were satisfied with the postoperative appearance. Conclusion: Endoscopic thyroidectomy through anterior chest wall combined with low-pressure subcutaneous CO 2 insufflation is a feasible and safe procedure. It can bring satisfactory cosmetic results. It is believed that endoscopic thyroidectomy by such approach will find a role in the future.
