胸乳入路腔镜手术治疗甲状腺乳头状癌24例

目的：总结胸乳入路腔镜手术治疗甲状腺微小乳头状癌的手术经验并评估疗效。方法回顾性分析2011年6月至2014年5月期间在我院肝胆甲乳外科行胸乳入路腔镜下甲状腺乳头状癌手术的24例患者的临床资料。结果全部24例患者均在腔镜下成功实施甲状腺乳头状癌根治手术，8例行患侧腺叶全切，10例行患侧腺叶全切加峡部及对侧腺叶大部分切除，6例行甲状腺全切除术，7例术中清扫中央区淋巴结。术后短暂性声音嘶哑2例，低钙血症2例，吞咽疼痛3例，胸前皮肤红肿、淤斑1例，颈部术口区积液1例。术后病理诊断均证实为甲状腺乳头状癌，中位随访时间24个月，平均6~42个月，无复发病例，全部患者对美容效果满意。结论乳晕入路腔镜甲状腺切除术治疗甲状腺乳头状癌具有切口小、恢复快、美容效果好等优点，是一种兼顾安全可行及外观美容的方法。

Clinical effect of endoscopic thyroidectomy via the areola of breast approach in the treatment of 24 cases of ;thyroid papillary cancer

Objective To summarize the experience of totally endoscopic thyroidectomy (TET) in treating thy-roid papillary cancer and to evaluate its feasibility and the therapeutic result. Methods The clinical data of 24 cases of thyroid papillary cancer treated with TET via the areola of breast approach from June 2011 to May 2014 in our hospital were retrospectively analyzed. Results TET procedures were successfully performed in all 24 cases. Postoperative pa-thology confirmed that 24 cases were of papillary cancer. Lobectomy and subtotal thyroidectomy were performed in 8 and 10 cases, respectively, and total thyroidectomy was performed in 6 cases. In 7 cases, additional lymph node dissec-tion was performed. After treatment, there were 2 cases of transient hoarseness, 2 cases of hypocalcemia, 3 cases of swal-lowing pain, 1 case of breast skin redness, swelling and ecchymosis, and 1 case of subcutaneous hydorps. All the cases were followed up for 6~42 months, with a median of 24 months. No recurrence was found during this period. And pa-tients were all satisfied with the cosmetic effect. Conclusion Totally endoscopic thyroidectomy (TET) via the areola of breast approach have a small incision, quick recovery, good cosmetic therapy for thyroid papillary cancer.