经口腔前庭入路非充气腔镜甲状腺乳头状癌手术的安全性及可行性研究  

Clinical analysis of gasless transoral endoscopic thyroidectomy via oral vestibular approach for papillary thyroid carcinoma

作　　者：何高飞[1] 谢磊[1] 姜金汐 褚俊杰 李建波 陆晓筱 章德广[1] He Gaofei;Xie Lei;Jiang Jinxi;Chu Junjie;Li Jianbo;Lu Xiaoxiao;Zhang Deguang(Department of Head and Neck Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院头颈外科,杭州310016

出　　处：《中华普通外科杂志》2023年第3期173-177,共5页Chinese Journal of General Surgery

摘　　要：目的探讨无充气经口腔前庭入路腔镜甲状腺乳头状癌手术的安全性及可行性。方法回顾性分析2020年11月至2021年6月在浙江大学医学院附属邵逸夫医院头颈外科接受无充气拉钩悬吊法经口腔前庭入路腔镜甲状腺手术的39例甲状腺乳头状癌患者的临床资料。结果39例患者均在腔镜下顺利完成手术,无中转开放手术,平均手术时间为(142±35)min,术后平均住院时间为(4.1±0.8)d。甲状腺乳头状癌平均最大直径为(8.5±4.5)mm,平均清扫的中央区淋巴结数目为(7.7±5.9)枚。术后发生暂时性甲状旁腺功能减退2例,1个月均恢复正常;皮下积液1例,经皮置管引流后治疗痊愈;下唇及颏部皮肤麻木3例,6个月症状得到改善。随访过程中无肿瘤局部残留或复发。结论无充气拉钩悬吊法经口腔前庭入路腔镜甲状腺手术治疗甲状腺乳头状癌安全可行。Objective To study the safety and feasibility of gasless transoral endoscopic thyroidectomy though vestibular approach using self-retaining retractor for papillary thyroid carcinoma.Methods The clinical data of 39 papillary thyroid carcinoma patients undergoing gasless transoral endoscopic thyroidectomy were collected at Department of Head and Neck Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from Nov 2020 to Jun 2021.Results All cases successfully underwent laparoscopic surgery without conversion to open surgery.The mean duration of operation was(142±35)min,and the postoperative mean hospital stay was(4.1±0.8)days.The mean maximum diameter of the tumor was(8.5±4.5)mm,and the mean number of lymph node harvest of by central compartment dissection was 7.7±5.9.Postoperative complications were transient hypoparathyroidism in 2 cases but recovered in 1 month.Scalp hydrop in 1 patient,fading subsequently.Transient sensory change around the lower lip in 3 cases,which recovered in 6 months.No patient suffered from recurrent laryngeal nerve palsy or hematoma,no permanent hypoparathyroidism occurred,nor of the postoperative bleeding.Conclusion The gasless transoral endoscopic thyroidectomy viaoral vestibular approach is a feasible approach in selected papillary thyroid carcinoma patients.

关 键 词：甲状腺肿瘤 甲状腺切除术 内窥镜检查 

分 类 号：R736.1[医药卫生—肿瘤]