腔镜甲状腺切除术的初步临床经验与体会

目的:总结初期开展腔镜甲状腺切除术的手术经验与体会。方法:应用经胸乳、经腋乳入路行腔镜甲状腺手术7例,其中1例行双侧甲状腺部分切除术。结果:7例手术均获成功,手术时间75~165 min,平均(100.00±29.72)min;术中出血量10~30 ml,平均(15.00±7.07)ml。2例患者术后出现局部皮肤感觉减退,均于术后3周内恢复正常,余者均恢复顺利。术后随访6~14个月,平均(8.71±2.69)个月,效果良好,无明显疤痕、皮肤皱褶及复发病例。结论:腔镜甲状腺手术较传统手术美容效果好,但手术难度较高,术者需具备一定的腔镜手术基础,开展初期需严格把握手术适应证,术中出现镜下难以处理的问题应及时中转开放手术。

Preliminary clinical experience of endoscopic thyroidectomy

Objective ： To summarize preliminary experience of endoscopic thyroidectomy, and provide the reference for the ones who initially start such operation. Methods：The anterior chest wall breast and axillary breast approaches were used to complete endo- scopic thyroid lobeetomy in 7 cases,which included 1 case of bilateral partial thyroidectomy. Results：All operations were successful. There was no such case which converted to open conventional thyroidectomy. Operation time lasted 75 to 165 min,with the average of （100.00 ±29.72） rain, mean intraoperative blood loss was （15.00± 7.07 ） ml （range 10 to 30 ml）. There were 2 cases with local paresthesia, and they recovered no more than 3 weeks after the operation. All the other patients recovered smoothly. After following up of （ 8.71 ± 2.69） months （ range 6 to 14 months） after operation,all patients were found with good effect of cosmetology, no obvious scars or skin folds, and no recurrence. Conclusions：Endoscopic thyroidectomy can attain better cosmic appearance than the traditional opera- tion. But it is difficult, needs more or less endoscopic operation experience. In the early stage of starting endoscopic thyroidectomy,strict indications are needed. If it is too difficult to end the operation under endoscopy, timely conversion to open conventional way is the correct choice.