无充气经锁骨下腔镜甲状腺右叶切除+右侧中央区清扫1例视频报告

背景与目的 笔者团队经临床探索后从手术切口定位、手术路径及手术器械三方面对传统的锁骨下入路腔镜甲状腺手术进行了改进和创新，故撰写本文，以供同行参考。方法 结合手术视频，汇报笔者团队实施的1例无充气经锁骨下腔镜甲状腺右叶切除+右侧中央区清扫手术资料，并进行文献回顾与讨论。结果 手术在腔镜下顺利完成，总手术时间65 min，出血量约5 mL。术后恢复可，术后2 d拔管出院，总引流量100 mL，术后住院2 d。结论 改良无充气经锁骨下入路腔镜甲状腺手术治疗甲状腺乳头状癌安全可行，中央区清扫彻底，切口隐蔽性好，操作难度低，有临床应用价值。

A video report of a case of gasless endoscopic right thyroid lobectomy with right central lymph node dissection by trans-subclavian approach

Background and Aims After clinical exploration, our team has introduced improvements and innovations to the traditional trans-subclavian approach endoscopic thyroidectomy, focusing on surgical incision localization, surgical pathway, and surgical instruments. This article was written to serve as a reference for colleagues.Methods Utilizing surgical video footage, data of one case of gasless endoscopic right thyroid lobectomy with right central lymph node dissection by trans-subclavian approach performed by our team was presented, along with review of relevant literature and discussion.Results The operation was successfully completed under endoscopy, with a total operative time of 65 min and an estimated blood loss of about 5 mL. Postoperative recovery was satisfactory, and the patient was discharged with tube removal on the 2nd postoperative day. The total drainage volume was 100 mL, and the postoperative hospital stay was 2 d.Conclusion The modified gasless trans-subclavian approach endoscopic thyroidectomy for treating papillary thyroid carcinoma is safe and feasible, with thorough central neck dissection, excellent incision concealment, and low operative difficulty. So, it has clinical application value.