【摘要】 目的:探讨胸乳入路3D腔镜甲状腺切除术在甲状腺疾病外科治疗中的应用效果。方法:回顾分析2015年1月至2015年12月经胸乳入路行3D腔镜甲状腺切除术的56例患者的临床资料,其中26例良性结节行单侧次全切除,12例行双侧次全切除;10例甲亢患者行双侧次全切除术;7例分化型甲状腺癌患者行患侧全切对侧次全切除,1例行患侧全切对侧次全切除加中央组淋巴结清扫。结果:患者均顺利完成手术,无中转开放手术。手术时间40~165 min,平均(102.6±44.2)min;术中出血量5~50 ml,平均(16.2±7.7)ml;术后引流总量30~226 ml,平均(90.6±34.7)ml;术后引流时间2~4 d,平均(2.6±0.5)d;术后住院3~7 d,平均(4.3±1.7)d。术后1例发生一过性声嘶,无呼吸困难、窒息、抽搐、呛咳等并发症发生。结论:3D腔镜使甲状腺手术更精准、微创,具有广阔的应用前景。更多还原

【Abstract】 Objective:To study the clinical effect of 3 D endoscopic thyroidectomy via chest-breast approach in the treatment of thyroid diseases. Methods:The clinical data of 56 patients with thyroid diseases who underwent 3 D endoscopic thyroidectomy via chestbreast approach from Jan. 2015 to Sep. 2015 were retrospectively analyzed. Unilateral subtotal resection was carried out in 26 cases of benign nodule. Bilateral subtotal resection was carried out in 12 cases of benign nodule and 10 cases of hyperthyroidism. Ipsilateral total resection and contralateral subtotal resection were carried out in 7 cases of differentiated thyroid carcinoma. Ipsilateral total resection,contralateral subtotal resection and central lymph node dissection were carried out in 1 case of differentiated thyroid carcinoma. Results:Endoscopic thyroidectomy was completed in all the patients without conversion to open operation. The operation time was 40-165 min[mean(102. 6 ± 44. 2) min],the blood loss was 5-50 ml [mean(16. 2 ± 7. 7) ml],total volume postoperative drainage was 30-226 ml [mean(90. 6 ± 34. 7) ml],postoperative drainage time was 2-4 d [mean(2. 6 ± 0. 5) d],and the postoperative hospital stay was 3-7 d [mean(4. 3 ± 1. 7) d]. Transient hoarseness occurred in one case,but no other complications such as dyspnea,asphyxia,convulsions and choking occurred. Conclusions:3 D endoscopy brings a wide application prospect for thyroidectomy with high accuracy and minimal invasion.更多还原