胸乳入路腔镜包膜内甲状腺切除术的临床体会

目的:探讨经胸乳入路行腔镜包膜内甲状腺切除术的手术方法及应用价值。方法:回顾分析为36例患者经胸乳入路行腔镜包膜内甲状腺切除术的临床资料,其中结节性甲状腺肿24例,腺瘤11例,乳头状癌1例。结果:35例成功完成腔镜手术,1例术中病理诊断为乳头状癌改行传统甲状腺癌根治术。手术时间平均(110.3±55.2)min,术中出血量平均(3.1±0.8)ml,术后2～3 d拔除引流管,患者痊愈出院,无声音嘶哑、抽搐、皮下积液等并发症发生,术后患者满意度较高。结论:经胸乳入路行腔镜包膜内甲状腺切除术具有安全性高、美容效果佳等优点,手术并发症少,术后患者满意度较高,值得推广。

Clinical experience of endoscopic intramembrane thyroidectomy via chest-breast approach

Objective:To explore the techniques and the clinical value of endoscopic intramembrane thyroidectomy via chest-breast approach.Methods:The clinical data of 36 patients underwent endoscopic intramembrane thyroidectomy via chest-breast approach were retrospectively analyzed,including 24 cases of nodular goiter,11 cases of thyroid adenoma and 1 case of papillary adenocarcinoma.Results:The procedures were successfully performed in 35 patients and 1 patient was converted to open surgery after endoscopic intramembrane thyroidectomy because of papillary adenocarcinoma diagnosed intraoperatively.Mean operating time was about(110.3±55.2) min,blood loss was about(3.1±0.8) ml,the drainage tube was removed 2 to 3 days after operation and the patients were discharged,no hoarseness,convulsion,subcutaneous hydrops or other complication was found after operation,the patients were satisfied with the postoperative performance.Conclusions:Endoscopic intramembrane thyroidectomy via chest-breast approach is a safe and satisfying technique with good cosmetic result and few complications,which is worth popularization.