经胸乳入路腔镜与开放手术治疗甲状腺良性肿瘤对比研究  

Endoscopic thyroidectomy via breast approach versus conventional open thyroidectomy for benign thyroid tumor:a retrospective study

作　　者：赵霞[1] 张能维[1] 朱斌[1] 路夷平[1] 宫轲[1] 王桐生[1] 张东东[1] 

机构地区：[1]北京世纪坛医院腹腔镜中心,北京100038

出　　处：《中国实用外科杂志》2011年第5期423-425,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨经胸乳途径腔镜甲状腺手术治疗的安全性和可行性。方法回顾性分析北京世纪坛医院2005年12月至2009年10月收治的275例甲状腺良性肿瘤的临床资料。结果腔镜手术124例(腔镜组),开放手术151例(开放组),两组手术的切口引流量、术后对镇痛的需求、术后住院时间差异无统计学意义。腔镜组术中出血量[(24.52±9.87)mL]明显少于开放组[(39.67±25.88)mL],差异有统计学意义(P<0.05);但腔镜组手术时间[(127.66±34.83)min]长于开放组[(95.17±29.86)min],P<0.05;腔镜组住院费用显著高于开放组。腔镜组对手术美容效果满意度评分(8.94±0.81)明显高于开放组(5.74±1.61)(P<0.05)。两组均无术后大出血及喉返喉上神经损伤和甲状旁腺损伤等严重并发症。结论腔镜甲状腺手术具有切口小、出血少、美容满意度高等优点,是安全可行的手术方法。Objective To explore the safety and feasibility of endoscopic thyroidectomy via breast approach. Methods The clinical data of 275 patients with benign thyroid tumor admitted between December 2005 and October 2009 at Beijing Shijitan Hospital were analyzed retrospectively. Results One hundred and twenty-four patients underwent endoscopic thyroidectomy （endoscopy group） and 151 patients underwent conventional open thyroidectomy （open group）. There was no significant difference in the postoperative hospital stay, volume of drainage and the analgesic requirements between two groups. Blood loss was significantly less in endoscopy group than that in open group （24.52±9.87）mL vs （39.67±25.88） mL （P〈 0.05）, but operative time was longer in endoscopy group than that in open group （127.66±34.83） rain vs （95.17±29.86） min （P〈0.05）. The cost of hospitalization in endoscopy group was higher than that in open group. The degree of satisfaction for cosmetic outcome in endoscopy group was higher than that in open group （8.94±0.81）vs （5.74± 1.61） （P〈 0.05）. No severe postoperative complication was encountered, such as massive hemorrhage, injuries of the recurrent or superior laryngeal nerve, or parathyroid gland injury. Conclusion Endoscopic thyroidectomy has mini-open, less blood loss and excellent cosmetic benefits. Endoscopic thyroidectomy is feasible and safe for thyroid disease.

关 键 词：腔镜甲状腺手术 甲状腺良性肿瘤 开放甲状腺手术 

分 类 号：R6[医药卫生—外科学]