无充气耳后发际入路完全腔镜下甲状腺癌根治术效果初探

背景与目的：目前国内经耳后发际入路完全腔镜下甲状腺癌根治术鲜有报道。探讨该术式可行性及安全性。方法：2018年2月—2019年1月选取无充气耳后入路完全腔镜下和颈前切口甲状腺癌根治术各12例，比较两组临床特征、手术情况、术后并发症及美容满意程度。结果：腔镜组与开放组年龄、性别、肿瘤大小、住院时间、颈部疼痛、中央区淋巴结清扫数目相比，差异无统计学意义（P>0.05）；腔镜组平均手术时间［（88.1±13.8）min］较开放组［（60.4±9.4）min］更长，引流液总量［（134.2±62.0）mL］较开放组［（87.1±26.7）mL］更多（P=0.024）。腔镜组可获得更理想的美容满意度（P<0.01）。结论：无充气耳后发际入路完全腔镜下甲状腺癌根治术安全、可行，美容效果极佳，值得推广。

Preliminary evaluation of the endoscopic thyroidectomy using gasless postauricular crease and occipital hairline approach

Background and purpose: The endoscopic thyroidectomy using gasless postauricular crease and occipital hairline approach is rare in China. This study aimed to determine the clinical feasibility of this approach. Methods: Twelve patients who underwent endoscopic thyroidectomy and 12 patients who underwent neck surgery were analyzed from Feb. 2018 to Jan. 2019. The clinical features, surgical conditions, complications and cosmetic satisfaction between them were compared. Results: There was no significant difference in age, gender, tumor size, days of hospitalization, neck pain and the number of central lymph node dissection between the endoscopic group and the open group (P>0.05). The mean operating time of the endoscopic group［(88.1±13.8) min］ was longer than that of the open group［(60.4±9.4)min］, and the total amount of drainage［(134.2±62.0)mL］ of the endoscopic group was more than that of the open group ［(87.1±26.7)mL］ (P=0.024). The cosmetic satisfaction was superior in the endoscopic group (P<0.01). Conclusion: The endoscopic thyroidectomy using gasless postauricular crease and occipital hairline approach for thyroid cancer is safe, feasible, and cosmetic satisfying.