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
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.