经口腔前庭腔镜甲状腺手术临床分析  

作　　者：蒋金伟[1] 梁维军[2] 侯悠聪 

机构地区：[1]浙江大学医学院附属邵逸夫医院,310020 [2]新疆生产建设兵团第一师医院,843000 [3]浙江省永康市第一人民医院,321300

出　　处：《浙江临床医学》2022年第7期1037-1039,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨经口腔前庭腔镜甲状腺手术的安全性.方法回顾性分析2018年1月至2021年12月浙江大学医学院附属邵逸夫医院及新疆生产建设兵团第一师医院行口腔前庭腔镜甲状腺手术患者的临床资料,其中男2例,女49例;年龄15~59岁.记录手术时间,术中出血量,术后住院时间,淋巴结清扫数目及术后并发症,美容满意度评分等指标.结果1例患者中转开放,其余顺利完成,手术时间(233.02±31.23)min,术后住院时间(3.37±0.72)d,淋巴结清扫(6.75±3.42)枚,36例乳头状癌患者中16例出现中央区淋巴结转移,美容满意度评分(8.02±0.82)分.术后暂时性喉返神经损伤4例,暂时性甲状旁腺功能减退1例,皮下积液1例,皮下瘀斑4例,发声乏力2例,经过对症保守治疗后缓解.平均随访时间(21.08±16.83)月,均未出现复发或转移.结论经口腔前庭腔镜甲状腺手术安全可行,值得临床推广应用.Objective To explore the safety of transoral endoscopic thyroidectomy vestibular approach(TOETVA).Methods From January 2018 to December 2021,2 males and 49 females,aged from 15 to 59 years,received TOETVA in Sir Run Run Shaw Hospital,Zhejiang University School of Medicine and the First Division Hospital of Xinjiang Production and Construction Corps.Operative time,intraoperative blood loss,postoperative hospital stay,number of lymph node dissection,postoperative complications,aesthetic satisfaction score and other indicators were recorded.Results One patient was transferred to open surgery,the rest were successfully completed,the operation time was(233.02±31.23)min,the postoperative hospital stay was(3.37±0.72)d,lymph node dissection was(6.75±3.42),and 16 of 36 patients with papillary carcinoma had central lymph node metastasis.Beauty satisfaction score was(8.02±0.82).There were 4 cases of temporary recurrent laryngeal nerve injury,1 case of temporary hypoparathyroidism,1 case of subcutaneous effusion,4 cases of subcutaneous ecchymosis and 2 cases of voice weakness,which were relieved after symptomatic conservative treatment.The mean follow-up time was(21.08±16.83)months,and no recurrence or metastasis occurred.Conclusion TOETVA is safe and feasible and is worthy to promote.

关 键 词：甲状腺肿瘤 腔镜手术 安全 口腔前庭入路 

分 类 号：R653[医药卫生—外科学]