免注气锁骨下途径腔镜辅助甲状腺肿瘤切除术34例

目的探讨免注气锁骨下途径腔镜甲状腺肿瘤切除术的临床价值。方法局部麻醉下患侧锁骨下方做2-4cm切口,沿颈阔肌下平面分离至颈前区,使用皮肤拉钩及缝线牵拉方法建立无气体空间,利用超声刀分离行甲状腺肿瘤切除术。结果34例手术均成功,手术时间（120±30）min,术中出血量（20±12）ml。3例皮瓣下积液,1例切口感染,引流、换药后均治愈。34例随访1-30个月,平均18.5月,肿瘤无复发。结论免注气锁骨下途径腔镜甲状腺瘤切除术具有操作简单、安全、美观效果。

Gasless Video-assisted Endoscopic Thyroidectomy via the Infraclavicular Approach: Report of 34 Cases

Objective To evaluate the feasibility and advantages of gasless endoscopic thyroidectomy via the infraclavicular approach. Methods A single 2- to 4-cm infraclavicular incision was made at the ipsilateral side under local anesthesia. The subplastysmal plane was dissected up to the anterior neck to build a gasless space by mechanical method. Afterwards, by using ultrasonic scalpel,thyroidectomy was performed. Results The procedure was completed in 34 cases with a mean operation time of （120 ±30） min and mean blood loss of （20 ±12） ml. After the surgery, 3 patients developed subcutaneous fluid and 1 patient had incisional infection, all of the 4 patients were cured by conservative therapy. The 34 cases were followed up for 1 to 30 months with a mean of 18.5 months, during the period, none of them had recurrence. Conclusions Gasless endoscopic thyroidectomy via the infraclavicular approach is a simple and safe method with good cosmetic outcomes.