| 摘要: |
| 目的 探讨mini器械在胸乳径路内镜甲状腺手术（breast approach endoscopic thyroidectomy，BAET）中的临床应用价值。方法 回顾性分析第二军医大学长征医院普外三科2012年9月至2013年12月间在BAET中使用mini器械的40例患者，年龄（33.53±8.76）岁，肿块大小（21.10±10.96）mm。根据术中冰冻病理结果，行单侧腺叶切除19例，甲状腺次全切除术6例，甲状腺全切除术7例，甲状腺癌根治术8例。结果 40例使用mini器械的腔镜手术均顺利完成，无中转开放病例，均达到完整肿瘤切除的目的；手术时间（112.25±31.52）min，VAS-12 h（2.48±1.13）分，VAS-24 h（0.85±0.80）分，VAS-48 h（0.25±0.44）分，RSS（美容评分）为（8.75±1.26）分。术后出现暂时性低钙血症4例和喉返神经麻痹1例。结论 在BAET中使用mini器械使传统内镜手术的微创、美学效果等更加优化，同时并未增加手术难度及并发症发生的风险。 |
| 关键词: mini器械 内镜甲状腺切除术 美容技术 微创性外科手术 胸乳径路内镜甲状腺切除术 |
| DOI：10.16781/j.0258-879x.2017.02.0226 |
| 投稿时间：2016-06-01修订日期：2016-11-25 |
| 基金项目: |
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| Application of mini instrument in breast approach endoscopic thyroidectomy: a report of 40 cases |
| WANG Qiang,ZHANG Wei,SHAN Cheng-xiang,JIANG Zhi-guo,QIU Ming* |
(Department of General Surgery(Ⅲ), Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author) |
| Abstract: |
| Objective To explore the clinical value of mini instruments in breast approach endoscopic thyroidectomy (BAET). Methods We retrospectively analyzed the data of 40 patients receiving BAET with mini instrument in our department of Changzheng Hospital from Sep. 2012 to Dec. 2013. The average age of patients was (33.53±8.76) years old and the tumor size was (21.10±10.96) mm. According to intraoperative frozen pathology, 19 cases underwent unilateral lobectomy, six cases underwent subtotal thyroidectomy, seven cases underwent total thyroidectomy, and eight cases underwent radical resection of thyroid carcinoma. Results Forty BAET procedures with mini instruments were completed successfully without conversion to open operation, and the complete tumor resection was achieved in all cases. The average operative time was (112.25±31.52) min in the patients, and the VAS-12 h, VAS-24 h, VAS-48 h and RSS (cosmetic score) were 2.48±1.13, 0.85±0.8, 0.25±0.44 and 8.75±1.26, respectively. Four patients had temporary hypocalcemia and one had recurrent laryngeal nerve paralysis after operation. Conclusion Application of mini instruments in BEAT can make endoscopic thyroidectomy less invasive and can improve the cosmetic results, without increasing the surgical difficulty and complications. |
| Key words: mini instruments endoscopic thyroidectomy cosmetic techniques minimally invasive surgical procedures breast approach endoscopic thyroidectomy |
