完全乳晕入路与胸乳入路腔镜甲状腺切除术的比较研究  

A comparative study on the endoscopic thyroid operation via complete areola approach and chest breast approach

作　　者：卢强[1] 谢书勤[1] 李君久[1] 唐世龙[1] 张万宇[1] 张小兵[1] 孙达[1] 欧阳君[1] 

机构地区：[1]广东中山大学附属东华医院普通外科,广东东莞523110

出　　处：《宁夏医学杂志》2015年第8期691-693,共3页Ningxia Medical Journal

摘　　要：目的比较腔镜甲状腺手术中完全乳晕与胸乳两种入路方法的临床疗效,评价完全乳晕入路方法的可行性及疗效。方法回顾性分析行腔镜下甲状腺手术病例67例,全部为甲状腺单侧腺叶良性病变,其中22例行完全乳晕入路,45例行胸乳入路,比较两种入路手术的皮瓣分离面积、中转开刀率、手术时间、术中出血量、术后并发症、术后住院时间、切口满意度等临床资料。结果全部手术均由同一术者完成。完全乳晕入路组中15例完成腺叶次全切除术,7例完成腺叶全切除术。胸乳入路组中32例完成腺叶次全切除术,13例完成腺叶全切除术。全乳晕组1例患者术后出现暂时性声嘶,胸乳入路组2例患者术后出现暂时性声嘶。2组病人均无中转开刀,术后无气管、喉上神经、甲状旁腺损伤等并发症,2组病例手术时间、术中出血量、术后住院时间差异无统计学意义(P>0.05)。全乳晕入路组18例切口获得非常满意评价,4例切口获得基本满意评价,优于胸乳入路组(27例非常满意,17例基本满意,1例不满意;P<0.05)。结论全乳晕入路是安全可行的入路方法,比胸乳入路获得更满意的美容效果,但术野暴露不如胸乳入路,病例选择更为严格。Objective To compare the clinical curative effect of the endoscopic thyroid operation via complete areola approach with chest breast approach, and to evaluate the feasibility and the clinical effect of the different methods. Methods 67 cases with thyroid disease were selected to operate undergoing endoscopes and the data was retrospectively analyzed. All of them were unilateral thyroid gland benign lesions. 22 cases were acted via complete areola approach, while other 45 via chest breast approach. It was compared on the effect of both approaches using the clinical information such as the size of subcutaneous segregation area, the rate of turning into operate, the time of operation, the amount of bleeding in operation, postoperative complications, the hospitalization time after operation, the satisfac- tion of incision and so on. Results All operations were performed by the same surgeon. Via complete areola approach,7 cases were per- formed the thyroidectomy and 15 cases were performed the subtotal resection. Via chest breast approach, 13 cases were performed the thy- roidectomy and 32 cases were performed the subtotal resection. One of the complete areola approach team had temporary hoarseness, while two of the chest breast approach team had the same symptom. No one turned into operate or had postoperative comphcations like injury of the trachea, the superior laryngeal nerve, parathyroid glands after operation. The difference between the operation time, the amount of bleeding in operation and the hospitalization time after operation via different approaches made no statistical sense （ P 〉 0.05 ）. In the team via complete areola approach, 18 cases obtained the evaluation of very satisfactory ,4 cases obtained the evaluation of basic satisfac- tory, so it acted better than the team via chest breast approach （27 cases of very satisfactory, 17 cases of basic satisfactory and one case of unsatisfactory） （P 〈 0.05）. Conclusion The method of operating via complete areola approach is safe enough and feasi

关 键 词：腹腔镜 甲状腺手术 完全乳晕入路 

分 类 号：R653[医药卫生—外科学]