摘要
目的:探讨颏下入路无充气腔镜甲状腺手术可行性、安全性及外观满意度。方法:回顾性分析2020年11月—2021年4月在天津医科大学肿瘤医院接受颏下入路无充气腔镜甲状腺手术的7例患者的临床病理特征、手术情况、术后并发症以及术后外观满意度。结果:7例患者的平均年龄为(35.0±6.5)岁(范围:25~43岁);体质指数平均为(24.7±4.1)kg/m^(2)(范围:18.8~31.4 kg/m^(2));肿瘤最大直径平均为(1.5±1.1)cm(范围:0.4~3.6 cm)。7例患者中,行锥状叶及峡部切除术2例,单侧腺叶及峡部同侧中央区清扫术3例,全甲状腺切除+双中央区清扫术2例。手术时间平均为(205.0±108.7)min(范围:60~365 min);术后平均住院时间为(3.3±0.5)d(范围:3~4 d)。术后病理诊断结果:结节性甲状腺肿1例,甲状腺乳头状癌6例。术后1例全甲状腺切除患者出现暂时性低钙血症。无喉返神经损伤、永久性低钙血症、吞咽困难、呛咳等并发症发生。术后1个月随访,患者颈前术区无明显疼痛及麻木感,平视时切口隐藏于颏下,外观满意度较高。未发现肿瘤种植、复发或转移。结论:颏下入路无充气腔镜甲状腺手术的创伤小、安全可行且美容效果较好。
Objective:To investigate the efficacy,safety and cosmetic effect of submental approach in the gasless endoscopic thyroidectomy.Methods:The clinicopathological features,surgical conditions,postoperativ ecomplications and postoperative appearance satisfaction of 7 patients receiving gasless endoscopic thyroidectomy via submental approach(ETSA)in Tianjin Medical University Cancer Institute and Hospital from November 2020 to April 2021 were analyzed retrospectively.Results:The mean age of 7 patients was 35.0±6.5 years(range:25 to 43)and the mean body mass index was 24.7±4.1 kg/m^(2)(range:18.8 to 31.4).The tumor size ranged from 0.4 to 3.6 cm(mean:1.5±1.1 cm).Two patients underwent the resection of thyroid isthmus and pyramidal lobe,3 patients underwent unilateral lobectomy+isthmectomy+central lymph node dissection,and the other 2 patients were treated with total thyroidectomy+bilateral central lymph nodes dissection.The mean operation time was 205.0±108.7 min(range:60 to 365 min).The average postoperative hospital stay was 3.3±0.5 d(range:3-4 d).Papillary thyroid carcinoma was the final pathologic diagnosis in 6 patients and adenomatous goiter in one patient.Transient hypocalcaemia was seen in one patient.No recurrent laryngeal nerve injury,permanent hypocalcemia,dysphagia,choking and other complications occurred.After one month follow-up,the patient had no obvious pain and numbness in the anterior region of neck.The appearance satisfaction was favorable.No tumor implantation,recurrence or metastasis were found.Conclusion:ETSA is shown to be safe,minimally invasive,cosmetically excellent and advisable alternative for selected patients.
作者
王军轶
李亦工
桂岩
魏松锋
郑向前
WANG Junyi;LI Yigong;GUI Yan;WEI Songfeng;ZHENG Xiangqian(Department of Thyroid and Neck Tumor,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin’s Clinical Research Center for Cancer,Tianjin 300060,China;Department of Otolaryngology Head and Neck Surgery,First Hospital of Lanzhou University,Lanzhou 730030,Gansu Province,China)
出处
《肿瘤》
CAS
CSCD
北大核心
2021年第12期846-851,共6页
Tumor
基金
天津市自然科学基金(18JCYBJC92900)。
关键词
腔镜甲状腺手术
颏下入路
甲状腺肿瘤
微创手术
Endoscopic thyroidectomy
Submental approach
Thyroid neoplasms
Microtraumatic operation
