单孔腋下入路腔镜手术在甲状腺良 性疾病中的临床应用

Clinical application of single-incision endoscopic thyroidectomy in benign thyroid diseases via the axillary

摘要:

目的 研究单孔腋下入路腔镜甲状腺手术在甲状腺良性疾病手术中的可行性、安全性及美容效果。方法 回顾性分析2011年1月～2013年1月，88例经单孔腋下入路腔镜甲状腺手术术中术后情况；比较左右侧两组不同疾病部位的美容效果评分。结果 88例患者均行单孔腋下入路腔镜甲状腺手术，无中转开放手术。术中出血量：（30.2±16.6）mL；手术时间：（124.2±32.8）min；术后病理：甲状腺腺瘤38例，结节性甲状腺肿50例。术后第1天引流液量（98.3±34.8）mL；术后复查甲状腺功能及血清钙离子均正常范围内。平均住院时间（3.6±1.4）d；颈部感觉异常21例，术后1～3个月后无感觉异常；皮下积液3例，经穿刺抽液后治愈，无切口感染情况；暂时性喉返神经损伤3例，喉上神经损伤1例。均在术后3～6个月后恢复正常，无永久性损伤。无甲状旁腺损伤表现。美容效果评分优良，两组不同疾病部位的美容评分差异均无显著性（P >0.05）。结论 经单孔腋下入路腔镜甲状腺手术是安全的，可行的，美容效果优越。

Abstract:

【Objective】 To study clinical application of single-incision endoscopic thyroidectomy in benign thyroid diseases via the axillary. 【Methods】 88 cases with single-incision endoscopic thyroidectomy via the axillary were analyzed retrospectively from 2011 January to 2013 January ; The scores of two groups of different disease parts of left and right side effect of cosmetic results were compared. 【Results】 88 patients underwent single-incision endoscopic thyroidectomy via the axillary hadn't converted to open operation. The amount of bleeding (30.2±16.6) mL, operation time(124.2±32.8) min, postoperative pathology: 38 cases of thyroid adenoma, 50 cases of nodular goiter, liquid drainage first days after operation (98.3±34.8) mL, postoperative thyroid function and serum calcium were within the normal range. The average hospitalization time (3.6±1.4) days; neck sensory abnormalities in 21 cases, after 1 to 3 months no paresthesia; 3 cases of subcutaneous effusion, the puncture healing, no infection of incision; transient recurrent laryngeal nerve injury in 3 cases, 1 cases of laryngeal nerve injury. In the postoperative 3~6 months after the return to normal, no permanent injury. No parathyroid injury occurred. Score the excellent cosmetic results were no statistically significant differences between the two groups of different disease site beauty scores (P>0.05). 【Conclusion】 The single-incision endoscopic thyroidectomy via the axillary was safe and feasible, and of cosmetic effect.