完全乳晕入路腔镜甲状腺切除术  

Endoscopic thyroidectomy via the areola of breast approach

作　　者：王存川[1] 胡友主[1] 赖贞吾[1] 杨景哥[1] 陈鋆[1] 潘运龙[1] 许朋[1] 李进义[1] 

机构地区：[1]暨南大学附属第一医院普通外科,广州510630

出　　处：《中华外科杂志》2009年第14期1067-1069,共3页Chinese Journal of Surgery

摘　　要：目的探讨完全乳晕入路行腔镜甲状腺切除的可行性。方法2005年4月至2008年9月，对28例美容要求较高的女性患者施行完全乳晕入路腔镜甲状腺切除手术，平均年龄22．5（18～38）岁，其中结节性甲状腺肿25例，原发甲状腺功能亢进2例，甲状腺微小乳头状癌1例。观察和取标本孔位于右侧乳晕内缘（10mnl），右侧乳晕外缘（5mm）及左侧乳晕上缘（5mm）为操作孔。观察总结28例患者的手术结果。结果28例患者手术均成功，行甲状腺单叶腺体切除术5例、单叶次全切除术15例、双叶次全切除术3例、单叶近全切除＋对侧叶次全切除术4例、单叶全切＋中央区淋巴结清扫＋对侧叶次全切除术1例。平均手术时间60．7min（40～125min），平均出血5．8ml（2～15m1），术后住院时间3．1d（2—5d）。无甲状旁腺和喉返神经损伤等并发症出现。术后随访1—40个月无复发，全部患者均对切口美容效果表示满意。结论完全乳晕人路腔镜甲状腺切除手术具有较佳美容效果，安全可行。Objective To investigate the feasibility and safety of endoscopic thyroidectomy via the areola of breast approach. Methods Between April 2005 to September 2008, endoscopic thyroidectomy via the areola of breast approach was performed in 28 female patients. Of the patients, 25 cases presented with nodular goiter, 2 cases with Grave＇s disease and 1 case with minimum papillary carcinoma. The average age was 22. 5 years （range, 18-38 years）. A 10 mm trocar was placed on the medial border of the areola of the right breast for the videoscopy and removing specimens, and a 5 mm trocar was placed on the lateral border of the areola of the same breast as the assisted operation hole. Another 5 mm trocar was placed on the medial border of the areola of left breast as the main operation hole. The operation data was recorded and analyzed. Results M1 the 28 operations were successful. The procedures included one lobe total thyroidectomy in 5 cases, one lobe subtotal thyroidectomy in 15 cases, subtotal thyroidectomy in 3 cases, one lobe near total thyroidectomy ＋ the other lobe subtotal thyroidectomy in 4 cases, and one lobe total thyroidectomy ＋ the central group lymph node resection ＋ the other lobe subtotal thyroidectomy in 1 case. The average operation time was 60. 7 minutes （range, 40-125 minutes）, the average operation blood loss was 5.8 ml （range, 2-15 ml）, the average length of post-operative hospital stay was 3.1 days （range, 2-5 days）. No adverse effects was found after the operation, such as damage to the parathyroid gland and the laryngeal nerve. The patients were followed-up for 1 to 40 months with satisfactory results. All 28 patients were satisfied with the cosmetic effects of the operation. Conclusions Endoscopic thyroideetomy via the areola of breast approach produces an outstanding cosmetic effect, it is safe and feasible.

关 键 词：甲状腺疾病 甲状腺切除术 腔镜 乳晕入路 

分 类 号：R686[医药卫生—骨科学]