[1]丁毅,骆成玉,张键,等.经乳晕入路腔镜甲状腺切除术26例报道[J].中国微创外科杂志,2006,06(4):277-281.
　Ding Yi,Luo Chengyu,Zhang Jian,et al.Endoscopic thyroidectomy via areola of breasts approach in 26 cases[J].Chinese Journal of Minimally Invasive Surgery,2006,06(4):277-281.
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经乳晕入路腔镜甲状腺切除术26例报道()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
06
期数:
2006年4期
页码:
277-281
栏目:
出版日期:
2006-04-20

文章信息/Info

Title:
Endoscopic thyroidectomy via areola of breasts approach in 26 cases
作者:
丁毅; 骆成玉; 张键; 林华; 杨齐; 周永桥
首都医科大学附属复兴医院外科,北京,100038
Author(s):
Ding Yi;  Luo Chengyu;  Zhang Jian;  etal.
Department of General Surgery, Beijing Fuxing Hospital of Capital University of Medical Sciences, Beijing 100038, China
关键词:
腔镜; 甲状腺; 手术
Keywords:
Endoscope; 　Thyroid; 　Operation
分类号:
R653
文献标志码:
A
摘要:
目的探讨经乳晕入路腔镜甲状腺切除术的可行性.方法2003年3月～2005年9月,采用经乳晕入路腔镜甲状腺切除术26例.结节位于甲状腺右叶13例,左叶10例,双侧叶结节1例,原发性甲状腺功能亢进(Ⅰ度)2例;单发结节9例,多发结节15例;囊性结节5例,实性结节13例,囊实混合性6例;结节直径1～4 cm.术前诊断甲状腺腺瘤9例,结节性甲状腺肿15例,原发性甲状腺功能亢进2例,无临床诊断甲状腺癌.结果镜下手术成功25例,手术时间50～210 min,平均112 min,行甲状腺肿瘤摘除4例,单侧甲状腺大部分切除10例,双侧甲状腺大部分切除8例,甲状腺双叶次全切除加峡部切除3例;中转开放手术1例,为术中发现甲状腺癌并侵犯气管.病理诊断甲状腺腺瘤4例,结节性甲状腺肿18例,原发性甲状腺功能亢进2例,甲状腺癌2例.术后24～48 h拔除引流管,无神经或甲状旁腺损伤等并发症.26例术后住院3～6 d,平均4.2 d.25例随访3～33个月,平均13个月,无局部复发,美容效果满意.2例甲状腺癌随访9、11个月,无复发转移.结论经乳晕入路腔镜甲状腺手术可行,近期效果满意,切口隐蔽.
Abstract:
Objective　To explore the feasibility of endoscopic thyroidectomy through the approach of areola of breasts.　 M ethods　Endoscopic thyroidectomy via areola ofbreasts approachwas carried out in 26 cases from March 2003 to September 2005. Thyroid noduleswere right-sided in 13 cases, left-sided in 10 cases, bilateral in 1 case, and notpalpable in 2 cases ofhyperthyroidism (grade 1). Therewere 9 cases of solitary nodule and 15 cases ofmultiple nodules. The noduleswere cystic in 5 cases, solid in 13 cases, andmixed in 6 cases, with 1~4 cm in diameter. Preoperative diagnoses included 9 cases of thyroid adenoma, 15 cases of nodular goiter, and 2 cases of primary hyperthyroidism.　Results　The thyroidectomywas performed successfully under endoscope in 25 cases, with an operation time of 50~210 min (mean, 112 min), including 4 cases of tumor enucleation, 10 cases of unilateral partial thyroidectomy, 8 cases ofbilateralpartial thyroidectomy, and 3 cases ofbilateral subtotal thyroidectomywith isthmus resection. A conversion to open surgerywas required in 1 case owing to thyroid carcinomawith trachea involvement. Pathological findings showed 4 cases of thyroid adenoma, 18 cases of nodular goiter, 2 cases of primary hyperthyroidism, and 2 cases of thyroid carcinoma. The drainage tubeswere removed at24~48 hours after operation. No nerve or parathyroid injuries occurred. The length of postoperative hospital staywas 3~6 d (mean, 4. 2 d). Follow-up observations in 25 cases for3~33 months (mean, 13 months) revealed no local recurrence. The patientswere satisfied with cosmetic effects. The 2 cases of thyroid carcinoma were followed for 9 and 11 months, respectively, presenting no recurrence or metastasis.　Conclusions　Endoscopic thyroidectomy via areola of breasts approach is feasible and effective, offering satisfactory cosmetic outcomes.

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更新日期/Last Update: 2014-01-27