摘要
目的探讨乳晕径路腔镜甲状腺手术的可行性和优点。方法2002年8月～2005年5月，采用胸部乳晕径路行腔镜甲状腺手术113例。术前诊断甲状腺腺瘤46例，结节性甲状腺肿62例，甲状腺功能亢进5例。结果成功完成手术112例，1例因出血中转开放手术。肿瘤大小为0.8—7cm，（2．3±1．6）cm，手术时间50-310min，（136．7±58.0）min，包括冰冻病理检查时间（30-40min）。术中出血量为10—200ml，（42，5±62．7）ml，术后引流量为15—310ml，（87．1±78.1）ml，术后恢复活动时间1—4d，（2.2±0．9）d，术后住院时间为2—9d（5.5±1．9）d。术后用镇痛药18例。并发症6例，其中2例喉返神经损伤，1例喉上神经损伤，1例术后出血，1例低血钙，1例术后甲亢复发。术后病理为甲状腺腺瘤43例，结节性甲状腺肿58例，甲状腺功能亢进5例，甲状腺癌3例，桥本甲状腺炎4例。结论乳晕径路腔镜甲状腺手术是一种安全可行的手术方法，对合适的病例可以作为首选方法。
Objective To explore the feasibility and advantages of endoscopic thyroidectomy via breast areola approach. Methods Endoscopic thyroidectomy via breast areola approach was performed in 113 cases between August 2002 and May 2005. Preoperative diagnosis included 46 cases of adenoma, 62 cases of nodular goiter, and 5 cases of Graves＇ disease. Results The operation was successfully completed endoscopically in 112 cases, and was converted to conventional thyroidectomy in 1 case because of bleeding. The tumor was 2.3 ± 1.6 cm in diameter （range, 0.8 ±7.0 cm）. The operating time was 136.7 ± 58.0 min （range, 50 - 310 m in）, the intraoperative blood loss was 42.5 ± 62.7 ml（ range, 10 -200 ml） , the postoperative drainage volume was 87.1 ± 78.1 ml （ range, 15 - 310 ml）, the time to resume normal activities was 2.2 ± 0.9 d （ range, 1 - 4 d ）, and the length of postoperative hospital stay was 5. 5 ± 1. 9 d（range,2 -9 d）. Out of the 113 cases, analgesic requirement was necessary in 18 cases （15. 9% ）. Postoperative complications occurred in 6 cases, including 2 cases of recurrent laryngeal nerve injuries, 1 case of superior laryngeal nerve injuries, 1 case of hemorrhage, 1 case of hypocalcemia, and 1 case of recurrence of Graves＇ disease. Pathological results showed 43 cases of thyroid adenoma, 58 cases of nodular goiter, 5 cases of Graves＇ disease, 3 cases of thyroid cancer, and 4 cases of Hashimoto＇s thyroiditis. Conclusions Endoscopic thyroidectomy via breast areola approach is a technically feasible and safe procedure. It can be employed as the first choice for indicated patients.
出处
《中国微创外科杂志》
CSCD
2006年第8期588-589,592,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
乳晕径路
腔镜
甲状腺切除术
Breast areola approach
Endoscopic
Thyroidectomy
