摘要
目的:探讨经胸壁三孔入路腔镜甲状腺切除术的可行性及优缺点。方法:2007年2月至2008年7月笔者采用经胸壁三孔入路法完成腔镜甲状腺切除术48例。其中甲状腺腺瘤14例,结节性甲状腺肿34例。对其临床资料进行总结。结果:47例成功完成手术,1例因术中出血中转开放。手术时间65～90min,平均70.5min,甲状腺肿瘤直径1.5～7.0cm,平均3.9cm。行甲状腺肿瘤挖除8例,单侧甲状腺腺叶切除6例,双侧甲状腺部分切除19例,单侧甲状腺次全切除15例,术后2～3d拔除引流管,2例术后声音嘶哑,但均于术后6个月内恢复,未发生甲状旁腺损伤及其他并发症。术后住院时间2～5d,平均4d,术后随访1～17个月,未发现复发病例。结论:腔镜甲状腺手术是一种安全的手术方法,和传统甲状腺手术相比手术效果相同,但切口更加微小、隐蔽,美容效果突出,其中经胸壁三孔入路腔镜甲状腺切除术操作简便,是比较理想的手术方法。
Objective：To evaluate the feasibility and clinical value of endoscopic thyroidectomy by the chest wall approach with 3-ports.Methods：Forty-eight patients were selected and given endoscopic thyroidectomy by the chest wall approach from Feb.2007 to Jul.2008.Results：Forty-seven cases were performed successfully by laparoscopy,1 case converted to open surgery due to bleeding.The mean operative time was 70.5min;the mean diameter of the mass was 3.9cm.Among these patients,there were 8 mass resections,6 total lobectomies,19 double-side mass resections and 15 subtotal lobectomies.The drainage tubes were removed at 2-3 days after the operation.Two cases were complicated by hoarseness,who had recovered in 6 months.No other complication was found,such as damage of parathyroid glands and so on.The postoperative hospital stay was 2-5 days,whose mean number was 4 days.During the follow-up of 1-17 months,no recurrence was found and there wasn＇ t scars in the neck due to the operation,which means all the patients were satisfied with the postoperative appearance.Conclusions：Endoscopic thyroidectomy by the chest wall approach is a feasible,effective and safe procedure,whose cosmetic appearance is much better than those of the traditional ways.The therapeutic effect of endoscopic thyroidectomy is as good as conventional operation.
出处
《腹腔镜外科杂志》
2009年第3期184-187,共4页
Journal of Laparoscopic Surgery
