经乳晕和经锁骨下二种途径的腔镜甲状腺手术比较

目的探讨经乳晕途径和经锁骨下途径的腔镜甲状腺手术的方法并比较其优缺点。方法采用经乳晕和经锁骨下途径的术式分别对12例和10例患者进行手术。结果经乳晕途径术式：12例结节均为单发,大小平均1．8cm;10例腔镜手术成功,2例中转;手术时间平均115min。出血量平均63ml。经锁骨下途径术式：9例为单发结节,1例为2个结节;大小平均4．2cm,腔镜手术均成功;手术时间平均85min;出血量平均66ml。22例患者均无并发症,对术后美容效果满意。二种术式在手术时间和肿瘤大小方面的差异具有统计学意义。结论经锁骨下途径术式适合较大肿瘤,其成功率高,创伤程度小于经乳晕途径术式,免充气且对腔镜技术和手术器械要求不高。

Endoscopic thyroid surgery: a comparison of the trans-subclavian and the trans-areolar approach

Objective To compare the adwantages and shortcomings of the endoscopic thyroid surgery by trans-subclavian approach and trans-areolar approach. Methods Twelve patients received the trans-areolar approach and 10 patients were given the trans-subclavian approach procedure. Results With the trans-areolar approach: the mean size of tumor was 1.8 cm, the mean operating time was 115 min, the mean blood loss during operation was 63 ml. Two patients converted to the conventional operation. With the trans-subclavian procedure: the mean size of tumor was 4.2 cm, the mean operating time was 85 min, the mean blood loss during operation was 66 ml. No complications were found in all of the patients and they were satisfied with the cosmetic effects of the procedures. There were signifcant differences in tumor size and operating time between the two operation types. Conclusions Compared with the trans-areolar approach, the trans-subclavian approach comes with less trauma, higher success rate and it fits for bigger tumor.