经胸乳入路腔镜甲状腺手术在甲状腺良性肿瘤中的应用

目的比较经胸乳入路腔镜甲状腺手术与传统甲状腺手术治疗甲状腺良性肿瘤的临床疗效。方法回顾性分析手术治疗的甲状腺良性肿瘤病人90例，其中腔镜组30例，接受经胸乳入路腔镜甲状腺手术；传统组60例，接受传统开放性甲状腺手术。比较2组病人的手术时间、术中出血量、术后首日引流量、术后住院时间、术后住院费用、术后并发症、术后首日疼痛评分以及对切口美观满意度，术后随访3个月。结果与传统组比较，腔镜组病人手术时间明显延长（P < 0.01），术中出血量、术后首日引流量均明显下降（P < 0.01），术后住院时间明显缩短（P < 0.01），术后首日疼痛评分明显降低（P < 0.01），而住院费用明显增高（P < 0.01）。2组病人均顺利治愈出院，术后并发症差异无统计学意义（P>0.05）。术后随访3个月，腔镜组病人术后切口满意度明显优于传统组（P < 0.01）。结论经胸乳入路腔镜甲状腺手术是一种安全、有效的手术方式，具有术中出血少、住院时间短、颈部瘢痕轻微、病人满意度高等优势。

Application value of the endoscopic thyroidectomy in benign thyroid neoplasms by trans-thoracoareolar approach

ObjectiveTo compare the clinical efficacy between endoscopic thyroidectomy by trans-thoracoareolar approach and traditional thyroidectomy in the treatment of benign thyroid tumors.MethodsThe clinical data in 90 benign thyroid tumor patients treated with operation were retrospectively analyzed.The patients were divided into the endoscopic group(30 cases treated with endoscopic thyroidectomy by trans-thoracoareolar approach) and traditional group(60 cases treated with traditional open thyroid surgery).Two groups were followed up for 3 months, and the operation time, intraoperative blood loss, drainage volume on the first day after surgery, postoperative hospitalization length, postoperative hospitalization costs, postoperative complications, pain score on the first day after surgery, and aesthetic satisfaction with incision were compared between two groups.ResultsCompared with the traditional group, the operative time significantly prolonged(P < 0.01), the intraoperative blood loss and drainage volume on the first day after surgery significantly decreased(P < 0.01), the postoperative hospital stay significantly shortened(P < 0.01), the postoperative pain score on the first day significantly decreased(P < 0.01), and the hospital stay cost significantly increased in the endoscopic group(P < 0.01).All patients were successfully cured and discharged, and the difference of the postoperative complications between two groups was not statistically significant(P>0.05).During the period of following up, the postoperative incision satisfaction in endoscopic group was significantly better than that in traditional group(P < 0.01).ConclusionThe endoscopic thyroidectomy by trans-thoracoareolar is safe and effective, and has the advantages of less intraoperative bleeding, short hospital stay, slight neck scar and high patient satisfaction.