经腋乳入路腔镜下小儿甲状腺腺瘤切除术的应用研究

目的：探讨小儿甲状腺腺瘤内镜手术治疗的可行性与疗效。方法回顾性分析2003-2013年我中心开展的35例经腋乳入路腔镜手术治疗的小儿甲状腺腺瘤临床资料，对内镜治疗小儿甲状腺腺瘤的手术适应证、禁忌证、手术方法、疗效进行讨论。结果35例患儿中，男9例，女26例，年龄6～14岁，平均10.2岁；其中单侧28例，双侧7例；腺瘤直径为0.8～5 cm，平均3.2 cm。均表现为颈部无痛性包块。所有病例均在内镜下成功完成甲状腺腺瘤切除术，无一例中转开放手术，无一例发生术后出血。1例术后出现可逆性声音嘶哑（术后4d内恢复），无永久性口周、四肢麻木和（或）手足痉挛、抽搐等。手术时间40～70 min，平均55 min；术中出血5～20 mL，平均10 mL；术后疼痛轻，均未使用术后镇痛；术后住院时间3～6 d，平均4．2 d。所有病例术后随访时间1～10年，无复发。切口瘢痕隐蔽，美容效果好。结论小儿甲状腺腺瘤的内镜手术治疗安全可靠，并发症少，相比传统手术，术后疼痛轻，恢复快，美容效果好。

Endoscopic thyroidectomy for thyroid adenoma in children

Objetive To investigate the feasibility and efficacy of endoscopic treatment for thyroid ade-noma in children. Methods A retrospective analysis of clinical characteristic on 35 thyroid adenoma patients which treatment by endoscopic in our center from the year 2003 to 201 3.Then discuss the indications,contrain-dications,surgical skills,efficacy of endoscopic thyroidectomy. Results In 35 case,the age from 6 to 1 4 years old,28 cases were simple side of thyroid adenoma and 7 cases were double sides. The mean diameter of adenomas were 3.2 cm（0.8~5 cm）. There were 9 boys and 26 girls. All the patientspresenting symptom were painless mass in neck.and underwent endoscopic thyroidectomy successfully.The mean operative time was 55 min（40~70 min）.The mean blood loss was 1 0 mL（5 ~20 mL）.The mean postoperative hospital stay was 4.2 days（3~6 days）.No case was transferred to opening surgery. No case was bleeding after surgery.1 patient occurred mild hoarseness and was recovered after 4days.No permanent horseness,limb numbness,convulsions, nor other complications. Conclusion Endoscopic thyroidectomy approach is a convenient and effective meth-od with good cosmetic results.