60例经胸乳入路腔镜甲状腺切除术的治疗体会  

Endoscopic thyroidectomy via the chest and breast:experience of 60 cases

作　　者：丁光耀[1] 王强[1] 金实[1] 董擂[1] 温鑫[1] 李开春[1] 李克军[1] 程雷[1] 

机构地区：[1]大连医科大学附属第一医院,辽宁大连116011

出　　处：《腹腔镜外科杂志》2016年第4期274-276,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨经胸乳入路腔镜下甲状腺手术的适应证、可行性、安全性及手术效果。方法:回顾分析2012年7月至2015年6月为60例直径<6 cm的甲状腺良性结节、腺瘤或乳头状癌患者经胸乳三孔入路行腔镜下甲状腺切除术的临床资料,观察手术时间、术中出血量、住院时间、结节大小、术后引流量、并发症等情况。结果:59例完成腔镜手术,1例因肿块较大、血供丰富、术中出血较多导致手术视野不清而中转开放手术。结节大小平均(3.0±1.2)cm;手术时间平均(2.0±0.7)h;术中出血量平均(16.0±8.6)ml。术后平均住院(7.0±5.5)d;术后引流量平均(30±14)ml。60例患者术后平均随访(12±5)个月,均无肿瘤复发,乳晕切口无瘢痕形成。结论:经胸乳入路腔镜下甲状腺手术的适应证包括甲状腺<6 cm的良性结节、腺瘤及部分甲状腺癌,手术安全、可行,术后颈部无瘢痕,美容效果较好。Objective：To evaluate the indications,feasibility,safety and effects of endoscopic thyroidectomy via the chest and breast.Methods：From Jul.2012 to Jun.2015,60 patients with benign thyroid nodules（〈 6 cm）,thyroid adenoma or papillary carcinoma of thyroid received endoscopic thyroidectomy in Department of Laparoscopy Surgery of the First Affiliated Hospital of Dalian Medical University.Three Trocars were used via the chest and breast during the surgery.Operation time,intraoperative blood loss,hospitalstay,nodule size,volume of drainage,postoperative complications and so on were observed.Results：Fifty-nine patients were treated successfully by laparoscopy and 1 case was converted to open surgery because of big size,abundant blood supplement of tumor,bleeding a lot in the surgery bringing about a bad exposure.The average diameter of tubers was（ 3.0 ± 1.2） cm.The mean operation time was（ 2.0 ±0.7） h.The average intraoperative blood loss was（ 16.0 ± 8.6） ml.The mean postoperative hospital stay was（ 7.0 ± 5.5） d.The mean volume of drainage after the surgery was（ 30 ± 14） ml.60 patients were followed up for（ 12 ± 5） months,during which no recurrence happened and no patient developed scars at the breast areolae.Conclusions：The indications of endoscopic thyroidectomy via the chest and breast include benign thyroid nodules（ 〈6 cm）,thyroid adenoma and some thyroid carcinoma.The operation is feasible and safe with excellent cosmetic effects owing to no scars in the neck.

关 键 词：甲状腺切除术 内窥镜检查 胸乳入路 

分 类 号：R736.1[医药卫生—肿瘤]