全乳晕入路腔镜甲状腺全切除术效果探讨  

Evaluation of clinical effects for bilateral thyroid nodules by endoscopic areola approach thyroidectomy

作　　者：鲍峰[1] 赵平武[1] 于颖娟[1] 龙煊[1] 

机构地区：[1]绵阳市中心医院普外科,四川绵阳621000

出　　处：《中国现代普通外科进展》2012年第11期859-862,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:评价全乳晕入路腔镜甲状腺全切除术的安全性和优劣性。方法:对2008年9月—2012年3月绵阳市中心医院收治的188例Ⅱ度肿大以内双侧甲状腺多发结节患者随机行全乳晕入路腔镜和开放甲状腺全切除术,观察其手术时间、术中出血量、住院时间、术中甲状旁腺暴露、术后并发症情况。结果:腔镜组和开放组手术时间分别为(83.85±14.18)min和(70.55±11.20)min(P<0.05),而术中出血量、住院时间、术中甲状旁腺暴露率、术后暂时性甲状旁腺功能减退发生率、永久性甲状旁腺功能减退发生率、术后暂时性喉返神经麻痹发生率、永久性喉返神经麻痹发生率分别为(10.0±4.12)mL和(10.5±4.59)mL、(3.3±0.97)d和(3.4±0.88)d、97.1%和95.8%、7.4%和10.8%、1.5%和1.7%、1.5%和4.2%、1.5%和0.8%(P均>0.05)。结论:Ⅱ度肿大以内的双侧甲状腺多发结节患者,采用全乳晕入路腔镜下甲状腺全切除术是安全有效的。Objective： To evaluate the safety and the advantages of the endoscopic areola approach thyroidectomy.Methods： A total of 188 cases were performed the endoscopic areola approach and open total thyroidectomy resection randomly from Sep.2008 to Mar.2012 in Mianyang central hospital.The operation time,hospitalization time,identification of parathyroid and recurrent laryngeal nerves（RLN）,and incidence of complications were compared between the two surgical procedures.Results： The laparoscopic group and the open group＇s operative time were（83.85±14.18） min and（70.55±11.20） min（P0.05）,but blood loss,the mean hospitalization time,the identification rate of parathyroid,the incidence rate of transient hypoparathyroid,the incidence rate of permanent hypoparathyroid,the transient RLN palsy,the permanent RLN palsy were（10.0±4.12） mL and（10.5±4.59） mL,（3.3±0.97） d and（3.4±0.88） d,97.1% and 95.8%,6.5% and 10.8%,1.5% and 1.7%.1.5% and 4.2%,1.5% and 0.8%（P0.05）,respectively.Conclusion： Endoscopic areola approach thyroidectomy is safe and effective for the benign bilateral multiple thyroid nodules withinⅡdegree of swelling.

关 键 词：甲状腺肿瘤 腔镜 微创手术 

分 类 号：R653[医药卫生—外科学]