CAJ | 학술논문

目的探讨经胸乳入路腔镜下甲状腺手术的临床应用.方法 2010年8月至2011年11月,福建省立医院对甲状腺＜6 cm良性结节或腺瘤90例,经乳沟1.2 cm、乳晕1 cm或0.5 cm三孔入路腔镜下超声刀行甲状腺切除术,观察手术时间、术中出血、平均住院日、并发症等情况.结果 89例腔镜下完成手术,1例因术中快速冰冻提示甲状腺癌并中央区淋巴结转移中转开放手术.平均手术时间100(90 ～240) min；平均术中出血量20(10～ 120) ml.术后平均住院时间6(3～12)d.85例术后平均随访6(3 ～13)个月,均无肿瘤复发,乳晕切口无瘢痕形成.结论经胸乳入路腔镜下甲状腺手术近期疗效满意,安全可靠,颈部无瘢痕,美容效果好.
목적 탐토경흉유입로강경하갑상선수술적림상응용.방법 2010년8월지2011년11월,복건성립의원대갑상선＜6 cm량성결절혹선류90례,경유구1.2 cm、유훈1 cm혹0.5 cm삼공입로강경하초성도행갑상선절제술,관찰수술시간、술중출혈、평균주원일、병발증등정황.결과 89례강경하완성수술,1례인술중쾌속빙동제시갑상선암병중앙구림파결전이중전개방수술.평균수술시간100(90 ～240) min；평균술중출혈량20(10～ 120) ml.술후평균주원시간6(3～12)d.85례술후평균수방6(3 ～13)개월,균무종류복발,유훈절구무반흔형성.결론 경흉유입로강경하갑상선수술근기료효만의,안전가고,경부무반흔,미용효과호.
Objective To evaluate the clinical application of endoscopic thyroidectomy via the breast areolae.Methods From Aug.2010 to Nov.2011,90 patients with benign thyroid nodules(＜6 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,1 cm or 0.5 cm away from the left and right breast areola to place the trocars.Ultrasonic harmonic scalpel was used to remove the thyroid nodules.Results 89 patients were treated successfully by endoscopy and 1 case was converted to open surgery because of thyroid cancer with central lymph node metastasis diagnosed by intraoperative rapid pathological assessment.The medium operation time was 100 minutes,ranging from 90 to 240 minutes.The average intraoperative blood loss was 20 ml,ranging from 10 to 120 ml.The mean postoperative hospitalization stay was 6 days(ranging from 3 to 12 days).85 cases were followed up from 3 to 13 months with 6 months as the average,during which no recurrence happened and no patient developed scars at the breast areolae.Conclusion Endoscopic thyroidectomy via the breast areolae is feasible and safe with excellent cosmetic effects.