腔镜辅助与传统开放甲状腺切除术的对比研究

目的探讨腔镜辅助甲状腺手术的安全性、微创性及美容效果。方法比较我院行腔镜辅助下甲状腺手术230例，传统开放甲状腺手术204例的两种术式手术时间、术后住院时间、切口美容评分、甲状旁腺损伤、神经损伤、切口感染率和复发率。结果腔镜组平均手术时间（33±29）min、术后平均住院时间（2±1）d，与开放组相比明显缩短（P值分别为0．025、0．000）；术中甲状旁腺损伤（1．30％）、一过性神经损伤（1．74％），与开放组相比均明显降低（P值分别为0．021、0．009）；术后美容满意度高（P=0．000）；切口感染发生率无明最差别（P=0．270）。随访6～30个月，两组复发率无差别（P=0.909）。结论腔镜辅助下甲状腺切除术有极佳的美容效果，手术时间短，术后住院时间短，特别是在降低甲状旁腺损伤，一过性神经损伤方面，具有明显的优势，是一种安全、有效的微创手术。

Study on comparison between video-assisted thyroidectomy and conventional thyroidectomy

Objective To study the safety, surrounding tissue injury and cervical wound appearance of the video-assisted thyroidectomy. Methods 230 patients had video-assisted thyroidectomy （ group endoscopy ） and 204 had conventional open thyroidectomy （group open）. Operative duration, postoperative hospital stay, complications, cervical wound healing and appearance, and recurrence rate were compared. Results Operative duration and postoperative hospital stay were （33 ±29）min and （2 ± 1 ）days for group endoscopy and （40 ± 21 ） min and （5 ± 2） days for group open （ P = 0. 025, P = 0. 000） respectively. Cosmetic result of wound evaluated by numeric scale was in favor of group endoscopy （P = 0. 000）. There were no significant differences in infection of incisional wound, between two groups （P = 0. 270）. After 6-30 months＇ follow-up, the recurrence rate showed no difference between two groups （ P = 0. 909 ）. Conclusions Compared with conventional surgery, endoscopic thyroideetomy for thyroid diseases was a practical and safe procedure with excellent cosmetic benefits, short hospital stay and less postoperative complications.