Peng W, Peng X W, Li Z
Department of Oncology Plastic Surgery/ Head and Neck Surgery, Hunan Cancer Hospital, the Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Changsha,410006，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Jul;32(13):972-975. doi: 10.13201/j.issn.1001-1781.2018.13.003.
To evaluate the feasibility and application value of transoral endoscopic thyroidectomy for benign thyroid nodule.Thirty-one patients with benign thyroid tumors underwent transoral endoscopic thyroidectomy via oral vestibular approach at our hospital between July 2016 and December 2017. Forty-five patients were enrolled as control group by conventional approach．Two groups were compared with regards to tumor size，types of operation, operation time， bleeding, volume of drainage, complication and postoperative hospital stay.Pathology examinations proved benign in both groups.Two groups were matched by age, sex, tumor size and types of operation. No statistical significance was found in volume of drainage, postoperative hospital stay and complication. Endoscopic group：no permanent glottic paralysis；one patient had transient hoarseness and recovered after 3 months. In one case，subcutaneous seroma was noted.One patient suffered from cervical subcutaneous emphysema. One patient had a epidermal damage of the ala nasi on the side of the nasal intubation, and recovered after one week. no permanent glottic paralysis；One patient had transient hoarseness and recovered after 3 months. No local infection at the incision site or within the cervical spaces occurred. No mental nerve palsy was observed. Control group： one patients occurred transient hoarseness and recovered after 3 months. No permanent recurrent nerve paralysis occurred; one patient suffered from local infection; one patient had subcutaneous seroma; one cases of postoperative hematoma occurred after 8 hours later. The average blood loss of endoscopic surgery was (20±4) ml, and the mean of operation time was (107±11) min. The difference was statistically significant between the endoscopic surgery and the conventional surgery.The novel transoral endoscopic thyroidectomy is feasible and safe，and it may be a good choice for patients with beauty needs.
评估经口内镜甲状腺切除术治疗良性甲状腺结节的可行性及应用价值。2016年7月至2017年12月，我院对31例良性甲状腺肿瘤患者采用经口前庭入路行内镜甲状腺切除术。选取45例患者作为对照组，采用传统手术方式。比较两组患者的肿瘤大小、手术方式、手术时间、出血量、引流量、并发症及术后住院时间。两组病理检查均证实为良性。两组患者在年龄、性别、肿瘤大小及手术方式方面相匹配。在引流量、术后住院时间及并发症方面，两组差异无统计学意义。内镜组：无永久性声门麻痹；1例患者出现短暂性声音嘶哑，3个月后恢复。1例患者出现皮下血清肿。1例患者发生颈部皮下气肿。1例患者鼻插管侧鼻翼表皮损伤，1周后恢复。无永久性声门麻痹；1例患者出现短暂性声音嘶哑，3个月后恢复。切口部位及颈部间隙均未发生局部感染。未观察到颏神经麻痹。对照组：1例患者出现短暂性声音嘶哑，3个月后恢复。无永久性喉返神经麻痹发生；1例患者发生局部感染；1例患者出现皮下血清肿；1例患者术后8小时后发生血肿。内镜手术平均出血量为(20±4)ml，平均手术时间为(107±11)min。内镜手术与传统手术比较，差异有统计学意义。新型经口内镜甲状腺切除术可行且安全，对于有美容需求的患者可能是一个不错的选择。
