无充气经腋窝后入路腔镜甲状腺微灶癌手术47例  

Endoscopic Thyroidectomy Through Gasless Axillary Posterior Approach for Thyroid Microcarcinoma

作　　者：刘岩 田志龙[1] 高新宝[1] 袁福康[1] 耿厚法 贾高磊[1] Liu Yan;Tian Zhilong;Gao Xinbao(Department of Vascular Thyroid Hernia Surgery,Xuzhou Central Hospital,Xuzhou 221006,China)

机构地区：[1]徐州市中心医院血甲疝微创外科,徐州221006

出　　处：《中国微创外科杂志》2022年第10期803-807,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：江苏省科教强卫青年医学人才重点项目(QNRC2016388)。

摘　　要：目的探讨无充气经腋窝后入路腔镜甲状腺微灶癌手术的安全性。方法2020年1月~2022年2月我院对47例甲状腺微灶癌行无充气经腋窝后入路腔镜甲状腺单侧腺叶和峡部切除联合中央区淋巴结清扫术。结果47例手术均顺利完成,无中转开放手术。手术时间65~145 min,(101.5±20.3)min。术中出血量5~40 ml,中位数15 ml。住院时间3~9 d,(6.0±1.4)d。术后病理:微灶乳头状癌;淋巴结清扫2~11枚,(4.7±1.9)枚。术后无严重并发生发生。术后美容满意程度评分表(9.2±0.7)分,满意度较高。47例术后随访2~26个月,平均12.2月,均未见肿瘤复发及颈部淋巴结转移。结论无充气经腋窝后入路腔镜甲状腺微灶癌手术安全可行,能很好地全程暴露喉返神经及保护甲状旁腺,美容满意度高。Objective To explore the safety of endoscopic thyroidectomy through gasless axillary posterior approach for thyroid microcarcinoma.Methods Clinical data of 47 patients with thyroid microcarcinoma undergoing endoscopic unilateral thyroid lobectomy with isthmus resection and central lymph node dissection through gasless unilateral axillary posterior approach from January 2020 to February 2022 were retrospectively analyzed.Results All the operations were successfully completed without conversion to open surgery.The operation time was 65-145 min,with an average of(101.5±20.3)min.The intraoperative blood loss was 5-40 ml,with an median of 15 ml.The total hospital stay was 3-9 d,with an average of(6.0±1.4)d.Postoperative pathology confirmed the diagnosis of papillary carcinoma.The number of lymph nodes dissected was 2-11,with an average of 4.7±1.9.There was no serious complication after operation.The average score on cosmetic satisfaction scale was(9.2±0.7)points,indicating high satisfaction.There was no tumor recurrence or cervical lymph node metastasis in the 47 cases during follow-ups for 2-26 months(mean,12.2 months).Conclusions Endoscopic thyroidectomy for papillary thyroid microcarcinoma through gasless axillary posterior approach is safe and feasible.It can well expose the recurrent laryngeal nerve and parathyroid gland,and has a good cosmetic effect.

关 键 词：腔镜 腋窝后入路 甲状腺微灶癌 淋巴结清扫 

分 类 号：R736.1[医药卫生—肿瘤]