经胸前径路腔镜甲状腺切除术与开放手术的临床比较

目的：比较经胸部途径腔镜甲状腺切除术与传统经颈部开放切除术的临床效果。方法：将58例适合行甲状腺单侧部分切除的患者分为腔镜组（29例）与开放组（29例）,分别行经胸部途径腔镜甲状腺切除术与传统经颈部开放切除术,比较其临床治疗效果。结果：腔镜组29例成功完成胸骨前入路腔镜甲状腺切除术,无中转。术中出血量腔镜组少于开放组,术后患者对手术的美容效果及术后疼痛满意度腔镜组优于开放组,住院费用、手术时间腔镜组均高于开放组,差异有显著性意义（P〈0.01）;局部麻木感、术后住院时间比较两组间差异无显著性意义;两组均无大出血、喉返神经等严重并发症发生。结论：经胸部途径腔镜甲状腺切除术与传统经颈部开放切除术比较,美容效果好、出血少、术后疼痛轻,但手术费用较高、手术时间长。

Comparative study between endoscopic thyroidectomy and conventional thyroidectomy

Objective：To compare the clinical efficacy of endoscopic thyroidectomy by the breast approach with conventional open thyroidectomy in patients.Methods：Fifty eight patients with one side nodular goiter were randomly divided into two groups.Patients in group 1 underwent endoscopic thyroidectomy by breast approach.Patients in group 2 underwent conventional open thyroidectomy.The therapeutic efficacy were observed and analyzed.Results： Endoscopic thyroidectomy by breast approach underwent successfully in 29 cases without conversion to conventional procedure.There was a significant difference in cosmetic result,postoperative pain,blood loss,median operating time,and hospital cost between two groups（P 0.01）.There was no significant difference in post-operative wound drainage,consumption of analgesic and hospital stay between two groups.No intraoperative or postoperative hemorrhage and recurrent laryngeal nerve injury occurred in either group.Conclusion： Endoscopic thyroidectomy by the breast approach has satisfactory cosmetic results,less postoperative pain,and less blood loss but longer operative time and higher hospital cost.