摘要
目的探讨内镜辅助下经颈部小切口行甲状腺切除术的可行性及其微创和美容效果。方法2003年8月-2005年8月昆明医学院第三附属医院头颈外科对17例患者分别经胸骨切迹上及颏下入路行内镜辅助下甲状腺手术。包括甲状腺腺瘤12例,分别行单侧甲状腺部分切除术11例,单侧甲状腺切除术3例,单纯峡部肿物切除术1例;结节性甲状腺肿2例,行双侧甲状腺部分切除术。结果本组胸骨切迹上入路12例,颏下入路5例,均获成功。手术切口1．5～3．0 cm,平均2．3 cm,无中转开放手术。手术时间30～120 min,平均61．3 min。术中出血10～40 ml,平均15．6 ml。术后引流6～40 ml,平均22．5 ml。术后住院时间3—6 d,平均4．5 d。无声嘶及低血钙并发症。术后随访1～12个月,无颈部皮肤僵硬感,除1例瘢痕体质外均对伤口美容效果满意。结论内镜辅助下的甲状腺手术在临床上是安全可行的,术后颈部美容效果较好。可根据肿物的位置选择合适小切口入路。
Objective To explore the feasibility of endoscope-assisted thyroidectomy with minimal neck incision. Methods Endoscope-assisted thyroid surgeries had been accomplished through incision above sternal notch and in submental area respectively from August 2003 to August 2005,including 11 partial lobectomy, 3 lobectomy, 2 two-sides partial lobectomy, 1 isthmectomy. Results In this group, 12 cases approached through above sternal notch , 5 cases approached through the submental area, and all were successful. The mean length of incisions was 2. 3 cm （ range from 1.5 cm to 3.0 cm ）. No one was converted to open surgery. The mean time of operation was 61.3 minutes （ range from 30 minutes to 120 minutes）. The mean volume of hemorrhage during the operation was 15. 6 ml （range from 10 to 40 ml）. The mean volume of drainage of post-operation was 22. 5 ml（ range from 6 ml to 40 ml） . The mean length of stay was 4. 5 days （ range from 3 days to 6 days）. There were no hoarseness and no low serum calcium. Following visits were performed after operation from 1 month to 12 months ,and there were no stiff feelings on skin. The cosmetic outcomes of the incisions were good, except 1 case for scar physique. Conclusions Endoscope-assisted thyroidectomy was safe and feasible with good cosmetic outcome. The selection of approach with minimal incision depends on the location of neoplasm.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2006年第7期521-523,共3页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
