Sasaki Akira, Nakajima Jun, Ikeda Kenichiro, Otsuka Koki, Koeda Keisuke, Wakabayashi Go
Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan.
World J Surg. 2008 Mar;32(3):381-5. doi: 10.1007/s00268-007-9375-x.
The aim of this study was to evaluate the feasibility and cosmetic results of endoscopic thyroidectomy by the breast approach for patients with thyroid diseases.
From August 1998 to July 2007, 92 patients with benign thyroid diseases underwent endoscopic thyroidectomy at our institution. Of these patients, 54 underwent thyroid lobectomy for a thyroid nodule, and 38 selected subtotal thyroidectomy for Graves' disease.
Ninety of the 92 procedures were successfully completed endoscopically. Mean operative time for thyroid lobectomy and subtotal thyroidectomy was 121.1 min and 231.9 min, respectively. Postoperative complications included one wound infection, one transient and one permanent recurrent laryngeal nerve palsy, one transient hypocalcemia, and five hypertrophic scars in the right breast medial margin. At 84 months of follow-up, one patient reported paresthesia in the anterior chest and one had experienced swallowing discomfort. Patient satisfaction was recorded as "satisfied," "equivocal," and "unsatisfied" in 54, 2, and 0 patients. Mean satisfaction score was 9.7, 9.5, 9.5, and 8.9 points in patients in their teens, 20s, 30s, and 40s, respectively, with an overall mean score of 9.3 points, showing more satisfaction in the young.
Endoscopic thyroidectomy by the breast approach for patients with thyroid diseases is an effective procedure that allows an excellent cosmetic result.
本研究旨在评估经乳晕入路内镜甲状腺手术治疗甲状腺疾病患者的可行性及美容效果。
1998年8月至2007年7月，我院对92例良性甲状腺疾病患者实施了内镜甲状腺手术。其中，54例行甲状腺结节甲状腺叶切除术，38例行Graves病甲状腺次全切除术。
92例手术中90例成功经内镜完成。甲状腺叶切除术和甲状腺次全切除术的平均手术时间分别为121.1分钟和231.9分钟。术后并发症包括1例伤口感染、1例暂时性和1例永久性喉返神经麻痹、1例暂时性低钙血症以及右乳内侧缘5例增生性瘢痕。随访84个月时，1例患者诉前胸感觉异常，1例有吞咽不适。患者满意度记录为“满意”“不确定”和“不满意”的分别有54例、2例和0例。十几岁、二十几岁、三十几岁和四十几岁患者的平均满意度评分分别为9.7分、9.5分、9.5分和8.9分，总体平均评分为9.3分，表明年轻人满意度更高。
经乳晕入路内镜甲状腺手术治疗甲状腺疾病患者是一种有效的手术方法，美容效果良好。
