中间人路腔镜甲状腺手术与开放手术的临床对比研究

目的对照分析由甲状腺中间人路行腔镜甲状腺手术与开放手术的临床疗效，探讨新人路腔镜甲状腺手术的可行性和优点。方法回顾性分析2008年8月至2010年12月中山大学附属第五医院微创中心采用甲状腺中间人路完成的腔镜甲状腺切除术192例（腔镜组）和开放甲状腺切除术240例（开放组）患者的临床资料，对照分析两组患者的年龄、手术时间、术中出血量、术后第1天引流量、术后住院时间、术后并发症等临床资料。结果腔镜组的手术时间为（112．5±42．7）min，明显长于开放组（52．6±30．8）min，两组比较差异有高度统计学意义（P〈0．01）。腔镜组术后第1天的引流量为（192．5±45．2）ml，明显多于开放组（44．0±28．7）ml，差异有高度统计学意义（P〈0．01）。两组患者的术中出血量、术后住院时间、术后并发症发生率等观察指标差异均无统计学意义。结论采用甲状腺中间入路新手术径路行腔镜甲状腺手术是一种安全、可行的方法，具有美容效果好、术后恢复快、术后并发症少的优点。

Clinical comparative study between conventional open thyroidectomy and endoscopic thyroidectomy by the new surgical approach in middle route

Objective To compare the clinical efficiency of endoscopic thyroidectomy with conventional open thyroidectomy by the new surgical approach in middle route in a prospective study. Methods Retrospective analyzed patients who undergone thyroid operations in our Minimal Invasive Center from August 2008 to December 2010,one hundred and ninety-two patients undernent endoscopic thyroidectomy by the new surgical approach in middle route (group endoscopy). Two hundred and forty patients undevwent conventional open thyroidectomy (group open). Age, operative time, blood loss, the volume of drainage in the first day after operation, time of postoperative stay and postoperative complications were compared. Results The operation time in group endoscopy was (112.5 ± 42.7) min, obviously longer than group open (52.6 ± 30.8) min, the difference was statistically significance (P < 0.01). The volume of drainage in the first day after operation in group endoscopy was (192.5 ± 45.2) ml, much more than group open (44.0 ± 28.7) ml, the difference was statistically significance (P < 0.01). The blood loss were both less, the time of postoperative stay were both short and the rates of postoperative complications were both lower in the two groups, and each difference was not statistically significance. Conclusions Endoscopic thyroidectomy by this new surgical approaches in middle route is a safe and feasible method, have advantages of excellent cosmetic results,quick recovery after operation, and less postoperative complications.