全乳晕入路腔镜下甲状腺微小乳头状癌手术的临床经验及疗效

目的：探讨全乳晕入路腔镜甲状腺微小乳头状癌的手术经验和疗效。方法：选取2016年6月至2017年12月中南大学湘雅二医院收治的甲状腺微小乳头状癌患者共117例，根据患者意愿分为腔镜手术组(n=72)和开放手术组(n=45)，比较两组中央区淋巴结清扫数、术中出血量、术后引流量及术后并发症发生和复发情况。结果：与开放手术组相比，腔镜手术组术中出血量少(P<0.05)、手术时间较长(P<0.05)；两组淋巴结清除数、术后引流量及并发症发生率的差异均无统计学意义(均P>0.05)；平均随访时间超过20个月，两组均无复发。结论：全乳晕入路腔镜下甲状腺微小乳头状癌手术并行中央区淋巴结清扫是安全可行的，具有颈部无痕、出血少、住院时间短等优点，更易被年轻患者所接受。

Clinical experience and efficacy of endoscopic surgery for papillary thyroid microcarcinoma through total areola approach

Objective: To investigate the experience and effi cacy of endoscopic thyroidectomy for papillarythyroid microcarcinoma (PTMC) through total areola approach.Methods: A total of 117 PTMC patients, who were diagnosed pathologically in Minimally InvasiveSurgical Center, Second Xiangya Hospital, Central South University from June 2016 to December2017, were divided into a endoscopic surgery group (n=72) and an open surgery group (n=45).The number of dissected central lymph nodes, blood loss, amount of drainage, occurrence ofpostoperative complication and recurrence were collected and compared.Results: Compared with the open surgery group, the blood loss was less and the operative time waslonger in the endoscopic surgery group (P<0.05). Th ere were no signifi cant diff erences betweenthe 2 groups in the number of dissected central lymph nodes, amount of drainage and occurrence ofpostoperative complication (all P>0.05). The mean follow-up time was more than 20 months, andthere was no recurrence in the 2 groups.Conclusion: Endoscopic thyroidectomy with central compartment neck dissection through totalareola approach is safe and feasible in patients with PTMC. It has many advantages, such as no scaron neck, less blood loss, shorter hospital stay and more acceptable to young patients.