内镜甲状腺切除术183例经验

目的探讨内镜甲状腺切除术的可行性及其美容效果的评价。方法采用胸部乳晕入路或腋下入路行内镜甲状腺切除术183例，其中甲状腺腺瘤56例（1例伴甲亢），结节性甲状腺肿88例（5例伴腺瘤，2例伴甲亢），原发性甲状腺机能亢进25例，甲状腺癌14例。结果成功完成手术179例，一侧腺体全切术123例，一侧全切加对侧部分切除或次全切除56例。手术时间93（45～280）min。中转开放手术4例。无神经、气管及甲状旁腺损伤等严重并发症。术后平均住院时间4（3～8）d。术后随访1～38个月，3例复发，患者均对手术的美容效果满意。结论内镜甲状腺切除手术是一种安全、可行的手术方法，具有良好的美容效果。

Experience with endoscopic thyroidectomy in 183 cases

Objective To sumarize the experience with endoscopic thyroidectomy. Methods Endoscopic thyroidectomy via the areola of breast approach or axillary approach was performed in 183 patients, including 56 patients with thyroid adenoma, 88 patients with nodular goiter, 25 patients with Graves'disease, and 14 patients with thyroid carcinoma. Results Endoscopic thyroidectomy was successfully performed in 179 patients including 123 receiving total thyroidectomy and 56 receiving total thyroidectomy plus partial or subtotal thyroidectomy, The operative time ranged from 45 to 280 min(mean 93 min). The operations was changed to open surgery in 4 patients. There were no complications such as damage to recurrent laryngeal nerve, bronchea or parathyroid glands. Postoperative hospital stay ranged from 3 to 8 days( mean 4 days). Follow-up for 1～38 months. showed recurrence in 3 patients. All of the patients were satisfied with cosmetic results.Conclusions Endoscopic thyroidectomy is a safe and effective method for thyroidectomy and with good cosmetic results.