摘要
目的：探讨经乳晕入路腔镜手术治疗胸骨后甲状腺肿的可行性、手术适应证及技巧。方法：2009年1月1日至2013年11月1日共收治18例胸骨后甲状腺肿患者,其中男4例,女14例,均行完全乳晕入路腔镜甲状腺切除术。结果：17例成功完成腔镜手术,1例因继发甲亢、胸骨后肿物过大过深且容易出血中转开放手术。术后病理均为结节性甲状腺肿。手术时间平均（82.1±8.0）min,术中出血量平均（37.2±19.2）ml,2-3 d拔除引流管;平均住院（7.8±1.5）d。术后8例出现一过性低血钙症状,无其他并发症发生及手术死亡病例。结论：经乳晕入路腔镜手术治疗胸骨后甲状腺肿是可行的,但胸骨后甲状腺组织体积大、位置低时,操作较困难,中转率较高,应严格把握手术适应证。
Objective： To investigate the feasibility,operation indications and surgical techniques of endoscopic thyroidectomy via areola approach in the treatment of substernal goiter. Methods： Clinical data of 18 patients（ 4 males,14 females） with substernal goiter treated by endoscopic thyroidectomy via areola approach between Jan. 1st 2009 and Nov. 1st 2013 were reviewed. Results： Endoscopic thyroidectomy via areola approach was successfully performed in 17 cases,one case was converted to open surgery due to secondary hyperthyroidism,and the substernal mass was very large and deep which was easy to bleed. Postoperative pathological diagnosis of all cases was nodular goiter. The mean operation time was（ 82. 1 ± 8. 0） min,the mean intraoperative blood loss was（ 37. 2 ± 19. 2） ml,drainage tube was removed in 2-3 d after surgery,and the mean postoperative hospital stay was（ 7. 8 ± 1. 5） d. No death and no complications were found except for temporary hypocalcemia in 8 cases. Conclusions： Endoscopic thyroidectomy via areola approach in the treatment of substernal goiter is feasible for most of the patients. But it is difficult to operate for the patients with very large and deep thyroid mass,and the conversion rate to open surgery is relatively high. The surgical indications should be strictly controlled.
出处
《腹腔镜外科杂志》
2014年第4期261-263,共3页
Journal of Laparoscopic Surgery
