目的 探讨内镜甲状腺切除术的可行性和安全性.方法 回顾性分析156例甲状腺切除术,按手术方式分为内镜组(内镜甲状腺切除术,n=76)和传统组(传统开放甲状腺切除术,n=80).比较两组的临床治疗效果.结果 156例甲状腺切除术均获成功,两组患者的术后住院时间、切口引流量及术后对镇痛的需求等无显著差异.与传统组比较,内镜组术中出血量明显降低(P＜0.05),手术持续时间明显延长(P＜0.05);住院费用显著增加(P＜0.05);患者对手术美容效果满意度明显提高(P＜0.05).两组均未发生术后大出血,喉返神经、喉上神经及甲状旁腺损伤等并发症.术后随访6个月,内镜组复发1例(1.32%),传统组复发2例(2.5%),复发病例病理检查结果均为结节性甲状腺肿.结论 内镜甲状腺切除术具有切口小、出血少及美容满意度高等优点,是可行而安全的手术方法.%Objective To explore the feasibility and safety of endoscopic thyroidectomy. Methods Retrospective analysis was conducted on 156 cases of thyroidectomy which were divided into endoscopic group(endoscopic thyroidectomy,n=76) and traditional group(traditional open thyroidectomy,n=80) according to different surgical approaches. Therapeutic effects were compared between the two groups. Results Thyroidectomy was successfully performed in 156 cases. No significantly differences were found in length of hospital stay, volume of drainage and postoperative analgesic requirements between the two groups. Compared with traditional group, the endoscopic group had larger intraoperative bleeding volume(P＜0.05), longer duration of surgery(P＜ 0.05),higher hospital charge(P＜0.05), and higher satisfaction degree of patients with cosmetic results of surgery (P＜ 0.05 ). No severe postoperative complications such as massive hemorrhage, recurrent laryngeal nerve, superior laryngeal nerve and parathyroid injury developed in the two groups. 6-month follow-up after surgery showed 1 case (1.32％) of recurrence in endoscopic group and 2(2.50 ％) in traditional group. Pathological results demonstrated all of these recurrence cases were nodular goiter. Conclusion Endoscopic thyroidectomy is a feasible and safe surgical approach with advantages of small incision,less bleeding and high degree of satisfaction with cosmetic results.
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