双侧甲状腺良性肿物行腔镜手术的临床研究  

Clinical Research of Totally Endoscopic Thyroidectomy for Bilateral Benign Thyroid Tumor

作　　者：魏文波[1] 廖康雄[1] 谢容明[1] 江树嵩[1] 蔡延庆[1] 陈秋凯[1] 侯贤琼[1] 卢晓裕 

机构地区：[1]广东省揭阳市人民医院普通外科一科,522000

出　　处：《中华全科医学》2013年第8期1216-1218,共3页Chinese Journal of General Practice

摘　　要：目的探讨双乳晕径路全腔镜下双侧甲状腺切除术的手术方法及临床应用价值。方法回顾性分析2009年1月-2012年12月25例腔镜下双侧甲状腺良性肿物切除术患者(腔镜组)的围手术期情况,从同期传统开放性双侧甲状腺切除术中抽取48例(开放组)作为对照,并对两组手术时间、术中出血量、术后镇痛、术后引流量、术后恢复活动时间、术后住院时间、术后并发症、总住院费用、美容效果、随访结果等方面进行比较分析。结果腔镜组25例均顺利完成手术。与开放组比较,腔镜组手术时间较长,术后引流量较多,住院费用较高,但腔镜组术中出血量较少,较快恢复正常活动,术后住院时间明显缩短,美容效果亦明显优于开放组(P<0.001),而镇痛需求方面的差异无统计学意义(P>0.05)。腔镜组术后并发症主要为胸前区皮肤麻木发紧感,开放组主要为出血,两组术后随访6～24个月,均无局部复发、无死亡病例,未发生永久性喉返神经麻痹、低钙抽搐等并发症。结论与开放性双侧甲状腺切除术相比,双乳晕径路全腔镜下甲状腺手术虽然手术时间偏长、住院费用较高,但安全可行且美容效果非常好,是治疗良性甲状腺肿物一种很好的手术方法。Objective To investigate the operative method and clinical value of totally endoscopic thyroidectomy via a bilateral-areola approach for the bilateral benign thyroid tumors.Methods Perioperative conditions of 25 patients（Endoscopic group） with bilateral benign thyroid tumor treated by totally endoscopic thyroidectomy via a bilateral areola approach from January 2009 to December 2012 were retrospectively analyzed.48 cases were randomly selected as a reference（Open group） from the patients underwent conventional open thyroidectomy during the same time.The operating time,operative blood loss,postoperative analgesic requirements,postoperative drainage volume,postoperative hospital stay,total hospital costs,cosmetic result,postoperative reactivation time,complications,follow-up result were compared between the two groups.Results The totally endoscopic thyroidectomy was accomplished smoothly in all the 25 cases.Compared to the open group,the operating time was longer,and postoperative drainage volume was more in endoscopic group,but the endoscopic group had less operative blood loss,shorter postoperative reactivation time,and shorter postoperative hospital stay than the open group.And a satisfactory cosmetic result was achieved in more cases in the endoscopic group（P 〈0.001）.The postoperative analgesic requirements and total hospital costs had no significant difference between the two groups（P〈0.05）.The common postoperative complications were skin numbness of anterior thoracic wall in the endoscopic group and hemorrhage were the most postoperative complications in the open group.The postoperative follow-up of 6 to 24 months revealed that there was no death case and no recurrence.No patients had permanent recurrent laryngeal nerve injury and tetany due to hypocalcemia.Conclusion Compared with the conventional open surgery,although with longer operation time and higher total hospital costs,the totally endoscopic thyroidectomy via a bilateral areola approach was still a feasible,practical and safe proc

关 键 词：腔镜 双乳径路 甲状腺良性肿物 甲状腺切除术 

分 类 号：R581.39[医药卫生—内分泌] R653.2[医药卫生—内科学]