达芬奇机器人手术系统在甲状腺切除术中的应用
Application of da Vinci robotic surgical system in thyroidectomy
目的 探讨达芬奇机器人手术系统应用于甲状腺切除术的安全性与有效性.方法 回顾性分析达芬奇机器人辅助的腔镜行甲状腺切除术20例的临床资料,其中甲状腺腺瘤5例、结节性甲状腺肿4例和甲状腺癌11例.甲状腺肿块长径最大5.33 cm.手术方式包括良性肿块行甲状腺单叶次全切除5例,单叶近全切除4例;甲状腺癌行双叶近全切除7例,双叶全切除4例,同时行中央区淋巴结清扫.结果 20例全部成功完成手术,无中转开放手术.手术时间平均206.4(105 ~372) min,术中失血平均27.3 ml.术后3~6 d拔除引流管.术后平均住院时间4.9 d,平均住院费用为60 172元.术后均无并发症.患者均对手术美容效果满意.结论 达芬奇机器人辅助的腔镜对甲状腺肿块切除术是一种安全而可行的方法,手术视野清晰,安全性高,美容效果显著.
更多Objective To discuss the safety and effectiveness of robot-assisted thyroidectomy using Da Vinci system.Methods Endoscopic thyroidectomy assisted by Da Vinci system was performed in 20 patients,including 5 cases of thyroidadenoma,4 cases of nodular goiter,and 11 cases of thyroid carcinoma.The max diameter of thyroid lump is 5.33 cm.Among 9 cases of benign thyroid neoplasm,5 cases underwent unilateral subtotal lobectomy,and 4 cases underwent unilateral near total thyroidectomy.Among 11 cases of thyroid carcinoma,7 cases underwent bilateral near total thyroidectomy,and 4 cases underwent bilateral total thyroidectomy,at the same time,all the 11 cases underwent central region lymph node dissection.Results The robot-assisted endoscopic thymidectomy was successfully carried out in 20 cases.The mean operation time was 206.4 (105~372)min.The mean operative blood loss was 27.3 ml.The draining tube was moved 3 to 6 days after surgery.The mean postoperative hospital stay was 4.9 days.The mean hospital expense was 60 172 yuan RMB.No complication occurred.20 patients were satisfied with the cosmetic effect and compararive curative effect.Conclusions The robot-assisted endoscopic thymidectomy is an efective method for thyroid diseases.The methed can get more clear vision,higher safety,and good cosmetic efect.
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