改进的内镜辅助下小切口在甲状腺手术中的临床研究(1)
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【摘要】 目的 探讨改进的内镜辅助下小切口术式在甲状腺肿瘤手术中应用的安全性以及与传统甲状腺手术的比较。方法 采用内镜辅助下小切口术式,从2006年4月至2008年12月在我科行内镜辅助下小切口各种甲状腺切除术式96例(腔镜组),选取同期传统各种甲状腺术100例作为对照(传统组)。比较两组手术时间、术中出血量、切口大小以及并发症等指标。结果 腔镜组手术时间为单侧(53.4±4.5)min,传统组为(49.0±3.2)min,传统组平均缩短约5 min(P<0.05);腔镜组双侧(78.7±6.2)min,传统组为(70.9±7.1)min,传统组平均缩短约9 min(P>0.05)。术中出血量腔镜组为单侧(5.6±0.3)ml,传统组为(18.8±1.5)ml,腔镜组平均减少约14 ml(P<0.01);腔镜组为双侧(7.6±0.6)ml,传统组为(25.2±1.7)ml,腔镜组平均减少约20 ml(P<0.01)。术后渗血、渗液腔镜组为单侧(22.3±2.1)ml,传统组为(30.4±3.2)ml,腔镜组平均减少约8 ml(P<0.01);腔镜组为双侧(27.6±3.6)ml,传统组为(38.2±3.7)ml,腔镜组平均减少约11 ml(P<0.01)。手术切口长度腔镜组(2.5±0.2)cm,传统组为(6.3±0.7)cm,传统组的手术切口长度比腔镜组长约4 cm(P<0.01)。腔镜组有3例发生暂时性喉返神经麻痹,传统组有2例喉返神经麻痹,1例发生甲状旁腺损伤,两组差异无统计学意义。结论 改进的内镜辅助下小切口甲状腺手术更符合微创理念,和传统手术相比,具有出血少、术后渗血渗液少,更具有美容效果。
【关键词】
内窥镜;甲状腺外科;小切口
Clinical application of Vidoassisted endoscopic thyroidectomy with technical modifications
XIONG Liangfa,JIA Ling,YANG Kunxian,et al.Department of Oncology,The First Affiliated Hospital of Yunnan Province,Yunan 650034,China
【Abstract】 Objective To evaluate the safety and efficacy of Vidoassisted endoscopic thyroidectomy and it compare with conventional thyroidectomy.Methods From April 2006 to December 2008,the clinical data of 96 consecutive patients received the endoscopic thyroid operation(ETO).The results were compared with those of the 100 patients in the same period using conventional techniques including operation time,the volume of bleeding,seeping of postoperation,the length of incisionand complication.Results The mean operetion time of subtotal thyroidectomy in ETO group was(53.4±4.5)min(single thyroidectomy)respectively,and 49.0±3.2 min respectively in conventional group.The operation time performed with ETO was 5 min slower(P<0.01)and 9 min slower with double thyroidectomy.the volume of bleeding and seeping in EPO group were both less than that in conventional group(P<0.01).About the length of incision,the EPO group was 4 cm shorter than that inconventional group(P<0 ......
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