改良式胸乳晕径路完全腔镜下甲状腺切除术122例临床报告  

122 cases of endoscopic thyroidectomies through modified chest and mammary areola approach

作　　者：陈健[1] 郑红梅[2] 江亮[1] 邓万凯[1] 李奇志[1] 刘细国[1] 樊大庆[1] 何家林[1] 

机构地区：[1]湖北省肿瘤医院头颈外科武汉,430079 [2]湖北省肿瘤医院乳腺外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第7期603-606,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2014年武汉市中青年医学骨干人才培养工程项目

摘　　要：目的：探讨改良式胸乳晕径路完全腔镜下甲状腺切除术的安全性和可行性。方法：回顾性分析122例采用不广泛分离胸部皮瓣的改良胸乳晕径路完全腔镜下甲状腺切除术患者的临床资料。结果：121例患者顺利完成手术,另1例术中中转为锁骨下小切口腔镜辅助手术;最大结节直径为（2.05±1.06）cm,手术时间为（88.61±27.87）min,出血量为（31.23±16.14）ml,术后引流时间为（3.54±0.88）d,总引流量为（139.09±95.93）ml;术后病理标本中检测到甲状旁腺9例,未见术后低钙抽搐;术后声音改变者6例;除1例中转手术,余患者美容效果满意。随访0~24个月,未见肿瘤复发和转移。结论：改良式胸乳晕径路完全腔镜下甲状腺切除术操作便利,可避免胸部皮瓣的广泛分离,美容效果满意,是安全有效的手术径路。Objective：To explore the safety and feasibility of endoscopic thyroidectomies through modified chest and mammary areola approach.Method：We retrospectively analyzed 122 cases of endoscopic thyroidectomies through a modified chest and mammary areola approach without extensive dissection of thoracic flap.The information about general status,surgical procedures and techniques,complications,etc.were summarized and discussedResult：One hundred and twenty-one cases were operated successfully while 1case was converted to video-assisted thyroidectomy through infraclavicular approach.The maximum diameter of the mass was（2.05±1.06）cm,mean operation time was（88.61±27.87）min,the operative blood loss was（31.23±16.14）ml,duration of postoperative drainage was（3.54±0.88）d and overall drainage volume was（139.09±95.93）ml.Parathyroid glands were detected in specimens of 9cases while no case of permanent postoperative hypocalcaemia was displayed.6cases of hoarseness were developed.One case experienced conversion surgery,all the others obtained satisfactory cosmetic result.All cases were followed up for 0-24 months without relapse and metastasis of the disease.Conclusion：Endoscopic thyroidectomy via a modified chest and breast areola approach can facilitated the procedure and avoid extensive dissection of thoracic flap,and proved to be safe and effective.

关 键 词：改良胸乳晕径路 完全腔镜 甲状腺切除术 

分 类 号：R653[医药卫生—外科学]