腔镜辅助下甲状腺手术与直视下小切口甲状腺手术的比较

目的探讨腔镜辅助下甲状腺切除术与直视下小切口甲状腺切除术的异同点,总结其各自的相对适用范围。方法将49例甲状腺占位病变患者按手术方式的不同分为2组,腔镜辅助下甲状腺切除术组（A组）21例,应用腔镜辅助行甲状腺手术,其中双侧甲状腺手术16例,单侧5例;直视下小切口甲状腺切除术组（B组）28例,在直视下小切口应用超声刀行单侧甲状腺中、下极手术。对2组患者的手术切口满意程度、手术时间、术中出血量、术后引流量及平均住院费用进行比较。结果 2组手术均顺利完成,未出现饮水呛咳、声音嘶哑、手足抽搐等不良反应,患者对切口的美观程度满意。A组和B组的手术时间分别为（91.19±11.06）、（52.86±10.40）min,术中出血量分别为（19.52±7.73）（、13.35±7.99）mL,术后引流量分别为（33.52±11.65）、（26.61±9.82）mL,平均住院费分别为（10 184.0±1 127.8）（、8 195.5±741.99）元（P〈0.05或P〈0.01）。结论 2组手术都具有一定的美容效果。腔镜辅助下甲状腺切除术相对更适宜于双侧甲状腺手术和甲状腺上极手术;直视下小切口甲状腺切除术在单侧、中下极甲状腺手术中不使用腔镜,减少了住院费用。

Comparison between Video-Assisted Thyroidectomy and Conventional Mini-Incision Thyroidectomy

Objective To compare the video-assisted thyroidectomy and conventional mini-incision thyroidectomy,and to define the scope of their respective application.Methods According to different surgical techniques,49 patients were divided into 2 groups.Twenty-one patients underwent video-assisted thyroidectomy（group A）,in which bilateral thyroidectomy were performed in 16 cases and unilateral thyroidectomy in 5 cases.Twenty-eight patients with middle or inferior thyroid mass within one lobe underwent conventional mini-incision thyroidectomy（group B）.Incision satisfaction,operation time,blood loss,postoperative drainage and the average cost of hospitalization were compared between the two groups.Results All operations were successfully completed with no complications,such as hoarseness and tetany.All the patients were satisfied with the incision.The operation time of video-sasisted thyroidectomy and conventional mini-incision thyroidectomy was（91.19±11.06）minutes and（52.86±10.40）minutes,respectively;The intra-operation blood loss of video-sasisted thyroidectomy and conventional mini-incision thyroidectomy was（19.52±7.73）mL and（13.35±7.99）mL,respectively;The post-operation draw water of video-sasisted thyroidectomy and conventional mini-incision thyroidectomy was（33.52±11.65）mL and（26.61±9.82）mL,respectively;The cost of hospitalization of video-sasisted thyroidectomy and conventional mini-incision thyroidectomy was RMB（10184±1127.8）yuan and RMB（8195.5±741.99）yuan,respectively（P〈0.05 or P〈0.01）.Conclusion Both of the operations are mini-invasive.Video-assisted thyroidectomy is relatively more suitable for bilateral thyroidectomy or superior thyroid operations,while conventional mini-incision thyroidectomy is more suitable for single lobe or middle inferior thyroid operations.