Abstract: ［Abstract］ Objective To report the surgical experience of endoscopic thyroidectomy with a small working. Methods Endoscopic thyroidectomy was carried out between December 2015 and December 2017 for 118 patients in our hospital. The patients were assigned to two group, small space group（S group, n=60）, a small working space（L group, n=58）according to the operative field. Results The operation time was similar in S group and L group, and the difference was not statistically significant（P>0.05）. S group had less bleeding than the L group（P<0.05）. Two cases had chest wall discomfort in S group, and most of L group had chest wall discomfort, and the difference was statistically significant（P<0.05）. The difference was statistically significant（P<0.05）in the subcutaneous effusion. The hoarseness occurred in both groups, and no statistically significant difference （P>0.05）. Conclusion Small working space endocospic thyroidectomy is a real cosmetic and minimally invasive operation , is also the future trend of thyroid surgery. Endoscopic thyroidectomy in a small working field is feasible and beneficial to the recovery of neck skin after operation.

Key words: small working space, thyroid nodule, laparoscope

摘要： ［摘要］ 目的 探讨小空间腔镜下甲状腺切除术临床手术效果。方法 回顾分析我院 2015 年 12 月至 2017 年 12 月间对 118 患者实施腔镜下甲状腺切除术的临床治疗。所有患者按手术空间分为小空间腔镜下甲状腺结节切除组（小空间组）60 例，普通空间腔镜组（常规组）58 例。观察两组手术效果及不良反应情况。结果 小空间组及常规组患者手术时间相当（P>0.05）；小空间组术后出血量及引流量均较常规组少，差异有统计学意义（P<0.05）；小空间组胸壁皮肤不适感少于常规组（2/60 vs 42/58，P<0.05）；小空间组无皮下积液发生，常规组5 例，差异有统计学意义（P<0.05）；两组术后声音嘶哑例数比较差异无统计学意义（P>0.05）。结论 小空间腔镜下甲状腺切除可行、有利于术后颈部皮肤的恢复。

关键词: 小空间, 甲状腺结节, 腹腔镜