甲状腺肿瘤专题研究(Monographic Study of Thyroid Surgery)

经口腔前庭腔镜NOTES 手术治疗甲状腺良性病变:附6 例报告

Published at: 2015年第24卷第5期

丁波泥 1 , 李小荣 1 , 官笑梅 1 , 杨开焰 1 , 胡桂 1 , 卢若煌 2
1 中南大学湘雅三医院普通外科,湖南 长沙 410013
2 中南大学湘雅三医院口腔科,湖南 长沙 410013
通讯作者 小荣 李 Email: lixiaorong_x@hotmail.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.05.006
基金:

摘要

目的:探讨经口腔前庭腔镜NOTES 手术治疗甲状腺良性疾病的可行性。方法:2013 年10 月—2014 年9 月, 对6 例甲状腺良性病变患者采用经口腔前庭入路腔镜甲状腺NOTES 手术。甲状腺结节位于右叶3 例,左叶3 例,均为单发结节;囊性结节1 例,实性结节4 例,混合性1 例;结节直径1~4 cm。术前诊断甲状腺腺瘤1 例,结节性甲状腺肿5 例。结果:6 例患者均成功实施经口腔前庭腔镜甲状腺NOTES 手术,平均手术时间122(100~150)min;平均术中出血30(10~40)mL。其中甲状腺部分切除5 例,单侧甲状腺大部分切除1 例,无1 例中转开放手术。病理诊断甲状腺腺瘤1 例,结节性甲状腺肿5 例。术后无神经或甲状旁腺损伤等严重并发症;平均住院时间8.2(8~10)d;随访3~13 个月无局部复发。结论:经口腔前庭腔镜NOTES 手术治疗甲状腺良性疾病是可行的,且切口隐蔽,美容效果满意。


Natural orifice translumenal endoscopic (NOTES) surgery through oral vestibule for benign thyroid disease: a report of 6 cases

Abstract

Objective: To evaluate the feasibility of natural orifice translumenal endoscopic (NOTES) surgery through the oral vestibule for benign thyroid disease. Methods: From October 2013 to September 2014, 6 patients with benign nodular thyroid disease underwent NOTES surgery through the oral vestibule. Three patients had a solitary right thyroid nodule, and 3 patients had a solitary left thyroid nodule; the nodule was cystic in one case, solid in 4 cases, and mixed in one case. The diameters of the nodules ranged from 1 to 4 cm. One patient was diagnosed as thyroid adenoma and 5 patients were diagnosed as nodular goiter before operation. Results: NOTES thyroidectomy through the oral vestibule was performed successfully in the 6 patients, with an average operative time of 122 (100–150) min and average intraoperative blood loss of 30 (10–40) mL. Of the patients, 5 cases underwent unilateral partial thyroidectomy, one case underwent unilateral subtotal thyroidectomy, and none required open conversion. Postoperative pathological examination revealed thyroid adenoma in one case and nodular goiter in 5 cases. No severe complications such as nerve or parathyroid injury occurred after operation. The average length of hospital stay was 8.2 (8–10) d, and there was no local recurrence during the follow-up period of 3 to 13 months. Conclusion: NOTES thyroidectomy through the oral vestibule for benign thyroid disease is feasible, and has a hidden incision and satisfactory cosmetic results.


comments powered by Disqus

全文

引用

引用本文: 波泥 丁, 小荣 李, 笑梅 官, 开焰 杨, 桂 胡, 若煌 卢. 经口腔前庭腔镜NOTES 手术治疗甲状腺良性病变:附6 例报告[J]. 中国普通外科杂志, 2015, 24(5): 648-652.
Cite this article as: DING Boni, LI Xiaorong, GUAN Xiaomei, YANG Kaiyan, HU Gui, LU Ruohuang . Natural orifice translumenal endoscopic (NOTES) surgery through oral vestibule for benign thyroid disease: a report of 6 cases[J]. Chin J Gen Surg, 2015, 24(5): 648-652.