经腋窝入路单孔内镜甲状腺切除术

Single port laparoscopic thyroidectomy through axillary approach

摘要:

目的 探讨经腋窝入路单孔甲状腺切除术的安全性和可行性。方法 2010年6月-2012年12月完成经腋窝入路单孔内镜甲状腺切除术11例，均为女性，平均年龄35.6岁（17～47），诊断甲状腺腺瘤2例，甲状腺单发结节8例，其中伴囊性变4例，甲状腺单侧多发结节1例。结节平均直径为3.2 cm（2.0～5.5）。对患者手术方式、手术时间、术中出血量、术后引流量、住院时间及美容满意度等进行记录和分析。 结果 11例手术均成功完成，未有中转多孔或开放手术。10例行甲状腺部分切除术，1例行单侧甲状腺大部分切除术。平均手术时间为130.5 min（100～180），术中平均出血量为19.5 mL（10～30），术后平均引流量为143.2 mL（25～190），平均住院时间为5.2 d（4～7），术后疼痛评分2.6分（2～5），切口满意度评分4.6分（3～5）。结论 在严格选择病例的基础上，腋窝入路单孔甲状腺切除术是安全、可行的。

Abstract:

【Objective】 To explore the feasibility and safety of single port laparoscopic thyroidectomy through axillary approach. 【Methods】 Single port laparoscopic thyroidectomy through axillary approach was performed between 2010 April to 2012 December. All the cases were female with the average age 35.6 yrs (17~47 yrs). Amongst them, 2 cases with adenoma, 8 cases with single nodule, 1 case with multiple nodules in unilateral side. The average size of the nodule was 3.2 cm (2.0~5.5 cm). The procedures, the operating time, the blood loss, the hospital stay and the satisfaction of cosmesis were recorded and analyzed. 【Results】 All the cases were accomplished successfully without conversion to multiple incision or open surgery. 10 cases underwent partial thyroidectomy, 1 case underwent subtotal throidectomy in unilateral side. The average operating time was 130.5 min (100~180 min), the average blood loss was 19.5 mL (10~30 mL), the average post-operative drainage was 143.2 mL (25~190 mL) and the average cosmetic score was 4.6 points (3~5 points). 【Conclusion】 For strictly selected patients, single port laparoscopic thyroidectomy through axillary approach is safe and effective.