不横断颈前肌群方法在传统及腔镜甲状腺切除手术中的应用

目的：探讨不横断颈前肌群的方法在经胸乳入路腔镜甲状腺切除手术中的应用价值。方法对昆明医科大学第二附属医院130例采用不横断颈前肌群方法甲状腺手术患者的临床资料进行回顾性分析，其中经胸乳入路腔镜甲状腺切除手术68例（腔镜手术组），传统甲状腺切除手术62例（传统手术组）。结果腔镜手术组手术时间（127．66±29．56）min较传统手术组（89．06±24．25）min长（P＜0．01），术中出血量（19．13±7．37）mL较传统手术组（50．17±29．28）mL少（P＜0．01）；腔镜手术组术后出现颈部痛性硬结1例较传统手术组7例少（P＜0．01）；腔镜手术组术后神经功能障碍4例，传统手术组3例，差异无统计学意义（P＞0．05）。结论经胸乳入路腔镜甲状腺手术不横断颈前肌群具有术中出血少、颈部痛性硬结发生率低、切口隐蔽、美容效果好等优点，手术安全可行。

Application of endoscopic thyroidectomy and conventional thyroidectomy by approach without transection anterior cervical muscle group

Objective To explore the application value of endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group .Methods The clinical data of 130 patients which treated by thyroidectomy without transection ante‐rior cervical muscle group were analyzed ,retrospectively .There were 68 cases treated by endoscopic thyroidectomy via breast ap‐proach and 62 cases treated by conventional thyroidectomy .Results 68 patients underwent endoscopic thyroidectomy ,the mean time of operation was(127 .66 ± 29 .56)min ,which was longer than that in conventional group (89 .06 ± 24 .25)min(P<0 .01) ,but blood loss was significantly less in endoscopy group than that in conventional group(19 .13 ± 7 .37)mL vs .(50 .17 ± 29 .28)mL . (P<0 .01) .The patients treated by endoscopic thyroidectomy with neck pain induration were less than that in conventional group (1 case vs .7 case) ,P<0 .01 ,and the nerve dysfunction were (4 case vs .3 case) ,P>0 .05 ,the nerve dysfunction had no significant difference .Conclusion Endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group has less blood loss ,lower neck pain induration rate ,hidden incisions and excellent cosmetic benefits .The method is safe and feasible .