[1]张超,王旺河,李国庆,等.经乳晕入路腔镜下甲状腺手术36例报告[J].中国微创外科杂志,2009,09(7):607-608.
　Zhang Chao,Wang Wanghe,Li Guoqing,et al.Experiences on Endoscopic Thyroidectomy via the Breast Areola: Report of 36 Cases[J].Chinese Journal of Minimally Invasive Surgery,2009,09(7):607-608.
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经乳晕入路腔镜下甲状腺手术36例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
09
期数:
2009年7期
页码:
607-608
栏目:
出版日期:
2009-08-25

文章信息/Info

Title:
Experiences on Endoscopic Thyroidectomy via the Breast Areola: Report of 36 Cases
作者:
张超; 王旺河; 李国庆; 田鹏; 张辉; 张建成
河南省人民医院外五科河南省腹腔镜治疗研究中心，郑州450003
Author(s):
Zhang Chao;  Wang Wanghe;  Li Guoqing;  et al.
Department of General Surgery, Endoscopic Treatment and Research Center of Henan Province, Zhengzhou 450003, China
关键词:
甲状腺肿瘤切除术; 内镜
Keywords:
Thyroidectomy; Endoscopy
分类号:
R653
文献标志码:
A
摘要:
目的探讨经乳晕入路腔镜下甲状腺手术的疗效。方法2004年8月～2008年5月甲状腺<5 cm良性结节或腺瘤，经乳沟1.2 cm、乳晕0.5 cm三孔入路腔镜下使用超声刀游离胸前区、颈前肌群，超声刀处理血管及腺体，完整腺体摘除或腺叶切除。结果35例腔镜下完成手术，1例因术中快速冰冻提示甲状腺癌中转开放手术。手术时间40~120 min，平均80 min ；术中出血量10~60 ml，平均40 ml。术后6 h下床活动，进流质，颈部引流管术后2 d拔除。1例术后皮下淤血，2周后消退。术后住院3~5 d，平均4 d。术后病理：甲状腺瘤28例，结节性甲状腺肿7例，甲状腺癌1例。35例术后随访3~24个月，平均12个月，均无肿瘤复发，乳晕切口无瘢痕形成，美容效果好。结论经乳晕入路腔镜下甲状腺手术近期疗效满意，安全可靠，手术切口隐蔽，颈部无瘢痕，美容效果好。
Abstract:
ObjectiveTo evaluate the efficacy of endoscopic thyroidectomy via the breast areola. MethodsFrom August 2004 to May 2008, 36 patients with benign thyroid nodules (<5 cm) received endoscopic thyroidectomy in our department. Three trocars were used during the surgery. Smallincisions were made at the points 1.2 cm away from the breast cleavage, and 10 mm and 5 mm away from the left and right breast areolae respectively to place the trocars. By using ultrasonic harmonic scalpel, the anterior area of the chest and the muscles of the anterior of the neck were freed, and the thyroid was removed completely.ResultsAmong the cases, 35 patients were treated successfully by endoscopy, the other one case was converted to open surgery because of thyroid cancer shown by intraoperative rapid pathological assessment. The operation time ranged from 40 to 120 minutes with a mean of 80 minutes. During the operation, the patient had 10 to 60 ml blood loss (average, 40 ml). They were permitted to get of the bed and intake liquid foods in 6 hours. The drainage tube that was indwelt in the neck was removed in 2 days. One patient developed subcutaneous ecchymosis and was then cured spontaneously in 2 weeks. The 36 patients were discharged from the hospital in 3 to 5 days (mean, 4 days). Postoperative pathological examination showed thyroid tumor in 28 cases, nodular thyroid hyperplasia in 7, and thyroid cancer in 1. Thirtyfive of the patients were followed up for 3 to 24 month with a mean of 12 months, during which no patient had recurrent tumors. None of them developed scars at the breast areolae.ConclusionsEndoscopic thyroidectomy via the breast areola is feasible and safe with excellent cosmetic benefits.

参考文献/References:

[1]王存川，陈鋆，胡友立,等.实用腹腔镜外科手术学.广州：暨南大学出版社，2002.297-301.
[2]吴东波，王存川.腔镜甲状腺切除术.中国微创外科杂志，2003，3：454-455.
[3]胡三元，亓玉忠，于文滨,等.腔镜甲状腺手术的临床研究.腹腔镜外科杂志,2004，8(2):65-66.
[4]李克军,赵作伟,董擂,等.腔镜甲状腺手术临床分析.腹腔镜外科杂志，2005，10(6):333-3344.
[5]黄彩平，嵇庆海，李端树,等.腔镜甲状腺手术应用于甲状腺癌可行性的病例分析.中华外科杂志，2008，46(6):416-417.
[6]仇明.内镜甲状腺手术意外出血常见原因及防治对策.中国实用外科杂志，2007，27（9）：690-691.
[7]Maeda S, Shimizu K, Minami S, et al. Videoassisted neck surgery for thyroid and parathyroid diseases. Biomed Pharmacother,2002,56(Suppl 1):S92-S95.
[8]李慎惠，张志勇，徐家朴，等.经胸入路腔镜下甲状腺肿块切除术.腹腔镜外科杂志，2005，10(2):70-71.

更新日期/Last Update: 2013-09-17