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1、腔镜与传统甲状腺手术的临床对比研究作者:罗光辉,苏兴桂单位:南方医科大学附属新会医院普外科,广东新会529100【摘要】目的:探讨腔镜技术用于甲状腺手术获得美容效果的临床应用价值及其安全性和微创性。方法:2006年5月至2008年8月,行甲状腺手术93例,其中腔镜甲状腺手术38例,传统开放甲状腺手术55例。比较网种术式的手术吋间、术中失血量、切口美容评分、术后住院吋间、住院费用、手术并发症和复发率。结果:两组手术均获成功,无出血、声嘶、低血钙等并发症。腔镜组与传统开放组相比,失血量少(14±10mlvs19
2、±15ml,=2.270,P=0.023),切口美容满意度高(VAS评分7.0±l.5vs2.0±1.4,=24.549,P=0.000),术后颈前无手术疤痕,无皮肤色泽改变,但手术时间长(70±20minvs60±30min,t=2.260,P=0.022),住院费用高(5843.5±897元vs4859.4±683元,t=4.463,P=0.000)。发生切口积液腔镜手术1例,开放组3例。随访2〜30个月,平均14个月,
3、复发2例,其屮腔镜组0例,传统组2例。结论:腔镜甲状腺手术与传统甲状腺手术相比,腔镜甲状腺手术可获得理想的美容效果,手术安全、恢复快,有着传统开放甲状腺手术不可比拟的优点,是治疗良性甲状腺疾病的理想手术方法。【关键词】腹腔镜检查;甲状腺切除术;微创TheClinicalComparativeStudyofLaparoscopicandTraditionalThyroidectomyLUOGuang-hui,SUXing-gui(XinhuiHospitalofNanfangMedicalCollege,Guangdong
4、Xinhui529100,China)Abstract:Objective:Toexplorethecosmeticadvantage,safetyandminimalinvasionoflaparoscopicthyroidectomy.Method:FromMar2006toAug2008,thereare93caseswereimplementedthyroidectomy.38caseswereunderwentlaparoscopicthyroidectomyand55caseswereunderwenttra
5、ditionalopeningthyroidectomy.Comparingtime,bloodloss,incisionscoreofbeauty,afterhospitalization,thecostofhospitalization,surgicalcomplicationsandrecurrenceratebetweenthetwosurgicaloperation.Result:Thesurgerywasperformedsuccessfullyinallpatients,andtherewasnobleed
6、ing,hoarseness,lowbloodcalcium,andothercomplications.Comparedwithopengroup,endoscopicgrouphadlessbloodloss(14±10mlvs19±15ml,t=-2.270,P=0.023),higher-satisfactioncosmeticincision(VASscore7.0&plusinn;1.5vs2.0±1.4,t=24.549,P=0.000),withoutscarsa
7、ndskincolorchangeafteranteriorsurgery,butthesurgeryhadalongtime(70±20minvs60±30min,t=2.260,P=0.022),thehighercostofhospitalization(5843.5±897yuanvs4859.4±683yuan,t=4.463,P=0.000).1caseofendoscopicgroupoccurredfluidinsurgicalincision,3c
8、asesofopengroup・Follow-up2to30months,anaverageof14months,2casesofrecurrence,0caseofendoscopicgroup,2casesoftraditionalgroup・Conclusion:Comparingwithtraditional