改良胸前壁入路腔镜手术治疗甲状腺疾病：附66例报告

目的 探讨腔镜技术在甲状腺疾病治疗中的临床应用价值.方法 采用胸前壁入路行腔镜甲状腺切除66例,其中甲状腺腺瘤7例,结节性甲状腺肿55例,甲状腺癌3例,继发性甲亢1例.结果 成功完成手术65例,1例因术中出血中转开放.行单侧次全切除术42例,双侧次全切除术21例,甲状腺癌3例中行单侧腺叶加峡部切除2例,甲状腺全切1例.手术时间94(50～180)min,术中出血量21(10～200)mL,住院天数9(5～19)d.无神经损伤及甲状旁腺误切等严重并发症.随访1～11个月,均无复发(包括3例甲状腺癌).结论 腔镜甲状腺手术具有安全有效、创伤小、恢复快的优点,可作为甲状腺良性病变治疗的首选治疗手段.

The clinical value of modifed endoscopic surgery via chest wall for thyroid disease:a report of 66 cases

Objective:To study the clinical value of endoscopic surgery for thyroid disease.
Methods:In 66 patients with thyroid disease, endoscopic thyroidectomy was performed, including 7 cases of thyroid adenoma,55 cases of nodular goiter,3 cases of thyroid cancer, and1 case of toxic nodular goiter.
Results:Among the 66 cases, endoscopic thyroidectomy was performed sucessfully in 65 cases, but 1 case was changed to open thyroidectomy. The operations  included unilateral sub-total thyroidectomy in 42 cases,and bilateral sub-total thyroidectomy in 21 cases; 3 in cases of thyroid cancer,total thyroidectomy was done in 1 case and unilateral total thyroidectomy plus isthmectomy was performed in 2 cases.The average operation time was 94(50-180)mins,while bleeding volume was 21（10-200）mlls and hospital stay was 9（5-19）days.There were no complications sucahs neural injury indavertent removal of parathyroid glands.No recurrence was found in 1 to 11 months follow up in all the cases（including 3 cases of thyroid cancer）.
Conclusions:Laparoscopic thyroidectomy can be carried out safely and effectively with minimal trauma and rapid recovery,and is the nethod of choice for benign lesion of thyroid.