关键词: 腹腔镜, 甲状腺次全切除术, 基层医院, 3D 系统

Abstract:

Objective To evaluate the efficacy for subtotal thyroidectomy from transvesical approach in primary hospital. Methods The clinical data of thyroid surgery patients in the Fifth Affiliated Hospital of Southern Medical University from September ，2013 to April ，2016 were analyzed. The patients underwent open surgery（open group，n=20），2D endoscopic surgery（2D group，n=20）and 3D endoscopic surgery （3D group ，n=20），respectively. The clinical data of thyroid surgery patients in Zhujiang Hospital were analyzed in same period and 30 cases were in each group. The operative time， intraoperative blood loss，postoperative drainage volume，postoperative hospital stay，complications，total operative complications，hospital costs and hospital data differences were compared between the three groups. Results The time of operation was 69.21±11.6 min in 2D group，56.22±6.57 min in 2D group and 40.93±10.6 min in open group（F=41.64，P<0.05）. The hospitalization cost of secondary hospital was 9733±1410 yuan，the cost of tertiary hospital was 11511±1749，and the cost of hospital was statistically different（t=-3.41，P<0.05）. The intraoperative blood loss，the postoperative drainage volume and the postoperative hospitalization were not significantly different. Conclusion Endoscopic subtotal thyroidectomy via a breast approach is safe ，effective，economical and practical as conventional surgery in primary hospital. The selection of 2D or 3D systems was based on the amount of operation annually.

Key words: laparoscopy, three?dimensional system, primary hospital, subtotal thyroidectomy