探索经腋下入路与胸乳入路行腔镜下单侧甲状腺切除术的临床疗效。

回顾性分析2014年4月至2017年8月行腔镜下单侧甲状腺切除术148例患者的临床资料，根据入路方式的不同，分为腋下组(83例)与胸乳组(65例)。采用Stata 14.2统计软件包进行统计分析，术中术后资料计量资料采用(±s)表示，比较采用独立t检验，并发症计数资料采用χ²检验，P<0.05为差异具有统计学意义。

腋下组患者手术时间低于胸乳组(P<0.05)，两组患者出血量、引流量、引流管留置时间与住院时间差异无统计学意义(P>0.05)。腋下组患者皮下积液低于胸乳组(P<0.05)，两组患者切口感染、甲状旁腺损伤、声音嘶哑的发生率差异无统计学意义(P>0.05)；腋下组患者术后满意度显著高于胸乳组患者(Z＝6.377，P＝0.000)。

经腋下入路腔镜下单侧切除甲状腺住院时间短、并发症少、患者满意度高，值得临床推广。

To explore the clinical outcome of endoscopic unilateral thyroidectomy by the axillary approach and the chest-breast approach.

From April 2014 to August 2017, clinical data of 148 patients underwent unilateral thyroidectomy were retrospectively analyzed. The patients were divided into axillary group (83 cases) and chest-breast group (65 cases). Statistical analysis were performed by using Stata 14.2 software package. Measurement data such as intraoperative and postoperative indicators were expressed as mean±standard deviation and examined by using t-test. The complication rate were compared by using chi square test. A P value of <0.05 was considered as statistically significant difference.

The operation time of the axillary group was significantly lower than that of the breast group (P<0.05). There was no significant difference in terms of the amount of bleeding, flow rate, drainage tube retention time and hospitalization time between 2 group (P>0.05). The subcutaneous hydrops in the axillary group were significantly less than those in the chest-breast group (P<0.05). There was no significant difference of incidence of incisional infection, parathyroid injury and hoarseness between 2 groups(P>0.05). The degree of postoperative satisfaction in the axillary group was significantly higher than that in the chest-breast group (Z=6.377, P=0.000).

Endoscopic unilateral thyroidectomy by the axillary approach has advantages including shorter of hospitalization, fewer complications and higher satisfaction, which is worthy of clinical promotion.