摘要
目的探讨腔镜下甲状腺切除术治疗结节性甲状腺肿的方法和可行性。方法2003年10月～2007年10月作者对收集的结节性甲状腺肿经胸乳晕入路行腔镜下甲状腺切除术,术后成功随访32例病例,其中男5例,女27例,年龄21～48岁,平均37岁。术前常规T3、T4、TSH测定排除甲亢患者。颈部彩色B超和CT检查证实为甲状腺实性或囊、实混合性占位病变,无颈部淋巴结肿大。结果全部病例腔镜下完成手术,其中单侧腔镜下甲状腺次全切除17例;一侧腔镜下甲状腺次全切除,另一侧部分切除15例。手术时间60～180min,平均90min,术中出血量15～80mL,平均40mL。无中转开放手术,无神经、甲状旁腺损伤及其他并发症发生,住院3～7d,均痊愈出院。病理结果均为结节性甲状腺肿。术后全部病例口服L2T4,随访1～48个月,乳沟、乳晕切口均愈合良好,无明显瘢痕,复查彩色B超均未复发。结论腔镜下甲状腺切除术治疗结节性甲状腺肿安全可行,疗效满意,与传统手术相比具有切口隐蔽,颈部美容的效果。
[Objective] To evaluate the method and feasibility of endoscopic thyroidectomy in nodular goiter. [Methods] Endoscopic thyroidectomy was performed by an anterior chest approach in 32 cases from October 2003 to October 2007. Among these cases five were male, twenty-seven were female. The ages ranged from 21-48 （mean, 37）. Routine examination T3,T4, TSH was performed to exclude hyperparathyroidism before operation. Cystic hyperplasia or consolidation was detected by color nltrasongraphy or CT scan. No enlargement was detected of the neck lymphatic node. [Result] All cases succeeded underwent endoscopic thyroidectomy, and 17 cases had subtotalectomy by endoscopic. Subtotalectomy was performed on one side of the neck, and partial thyroidectomy of 15 cases was performed on the other side of the neck. The operation time was 60-180 minutes, and the intraoperative blood loss was 15-80 mL （mean, 40 mL）. No conversion or damage of recurrent laryngeal or parathyroid glands was found. The length of postoperative hospital stay was 3-7 days. The pathologic diagnosis was nodular goiter. All cases took L2T4 after operation. Followed-up 32 cases for 1-48 months showed good cosmetic outcomes. Re-examinations with color nltrasonography revealed no recurrence. [Conclusions] Endoscopic thyroidectomy to treat nodular goiter is a safe and feasible procedure. The effect of therapy is satisfaction. As compared with conventional operation, it shows better cosmetic outcomes.
出处
《中国内镜杂志》
CSCD
北大核心
2008年第5期552-553,555,共3页
China Journal of Endoscopy
