经胸乳径路腔镜甲状腺手术与传统甲状腺手术治疗单侧甲状腺良性病变的对比研究

目的比较单侧甲状腺良性病变经胸乳径路腔镜甲状腺手术与传统甲状腺手术的差别,探讨经胸乳径路腔镜甲状腺手术的实用性及优越性。方法回顾性分析了2010年1月～2011年6月收治的单侧甲状腺良性病变患者的资料共50例,其中21例行经胸乳径路腔镜甲状腺手术,设为治疗组;另29例,行传统开放性手术,为对照组。比较两组手术时间、术中出血量、住院时间、术后并发症发生率、术后1年复发率及美容效果。结果两组患者手术均获成功。手术时间治疗组（48.34±13.52）min,显著长于对照组（36.31±12.15）min;术中出血量治疗组为（10.35±5.83）ml,显著低于对照组（26.23±8.21）ml;术后并发症发生率治疗组9.52%,对照组10.34%;术后住院时间治疗组为（3.45±0.51）d,显著低于对照组（4.24±1.06）d。术后1年随访治疗组及对照组均无复发病例。术后1年治疗组患者均对切口瘢痕满意,对照组有15例患者对切口瘢痕不满意。结论单侧甲状腺良性病变行经胸乳径路腔镜甲状腺手术安全可行,相对传统手术在切口美容方面更具优越性。

Comparison of endoscopic thyriodectomy via anterior chest wall approach and traditional thyriodectomy in the treat-ment of one-side benign thyroid pathological changes

Objective To compare the difference between endoscopic thyroidectomy via anterior chest wall approach and traditional thyroidectomy,to explore the practicality and excellence of endoscopic thyroidectomy via anterior chest wall approach.Methods 50 cases with one-side benign thyroid pathological changes received via anterior chest wall approach endoscopic thyroidectomy were analyzed retrospectively.21 cases of endoscopic thyroidectomy via anterior chest wall approach,was set to treatment group;another 29 cases,conventional open surgery,for the control group.The operative time,hemorrhage volume,hospital stay,incidence of postoperative complications,postoperative 1-year recurrence rate and cosmetic results evaluation were compared between the two groups respectively.Results Two groups of patients were performed successfully.Operation time of treatment group was（48.34±13.52）min,significantly longer than that of the control group（36.31±12.15）min;（10.35±5.83）ml blood loss of treatment group was significantly lower than that of the control group,（26.23±8.21）ml;incidence of postoperative complications of treatment group was 9.52%,control group was 10.34%;the postoperative hospitalization of treatment group（3.45±0.51）d,significantly lower than that of the control group,（4.24±1.06）d.1-year follow-up after the treatment group and the control group had no recurrence.Year after surgery,the treatment group were satisfied with the scar,but 15 patients in the control group complained with the scar.Conclusion One-side benign thyroid changes passing via anterior chest wall approach endoscopic thyroidectomy is safe and feasible,and with the advantage of cosmetic results.