腔镜下甲状腺手术21例报告

目的探讨腔镜下甲状腺手术的可行性。方法2003年3月～2005年9月我院对21例甲状腺良性病变采用胸骨前入路腔镜下手术。建立皮下隧道，CO2压力6mmHg，腔镜下超市刀行甲状腺部分或大部切除术。结果4例术中出血难以控制中转开放手术。余17例腔镜手术时间90～180min，平均125min；术中出血量10～50ml，平均31ml；术后引流量5～35ml，平均20ml。术后住院2～4d，平均3d。术后2例出现皮肤瘀斑及皮下脂肪液化，1例出现低钙、抽搐等甲状旁腺损伤症状。15例随访1～12个月，平均5个月，无复发及远期并发症发生。结论腔镜下甲状腺部分切除术有良好的美容效果，具有可行性。

Endoscopic thyroidectomy in 21 cases

Objective To investigate the feasibility of endoscopic thyroidectomy. Methods Endoscopic thyroidectomy was performed via breast approach in 21 cases of benign thyroid diseases from March 2003 to September 2005.A subcutaneous tunnel was established by CO_2 inflation at the pressure of 6 mm Hg.A harmonic scalpel was utilized to complete partial or subtotal thyroidectomy. Results Conversions to open surgery were required in 4 cases because of massive hemorrhage.Of the remaining 17 cases,the endoscopic operating time was 90~180 min(mean,125 min),the hemorrhage volume was 10~50 ml(mean,31 ml),the postoperative drainage volume was 5~35 ml(mean,20 ml),and the postoperative hospital stay,2~4 days(mean,3 days).Skin ecchymosis and subcutaneous fat liquefaction occurred in 2 cases,and parathyroid gland injuries with symptoms of hypocalcemia and hyperspasmia happened in 1 case.Follow-up observations in 15 cases for 1~12 months(mean,5 months) found no recurrence or long-term complications. Conclusions Endoscopic thyroidectomy is safe and feasible,with excellent cosmetic outcomes.