外科理论与实践 ›› 2025, Vol. 30 ›› Issue (01): 1-6.doi: 10.16139/j.1007-9610.2025.01.01

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无充气腋窝入路腔镜甲状腺手术的应用、创新与质控

郭雅文, 郑传铭(), 葛明华()   

  1. 浙江省人民医院(杭州医学院附属人民医院)耳鼻咽喉-头颈外科中心 头颈外科,浙江省头颈部恶性肿瘤临床医学研究中心,全省头颈肿瘤精准医学研究重点实验室,浙江 杭州 310014

Application, innovation, and quality control of endoscopic thyroidectomy by gasless unilateral axillary approach

GUO Yawen, ZHENG Chuanming(), GE Minghua()   

  1. Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College; Zhejiang Provincial Clinical Research Center for Head & Neck Cancer; Zhejiang Key Laboratory of Precision Medicine Research on Head & Neck Cancer, Zhejiang Hangzhou 310014, China
  • Received:2024-12-27 Online:2025-01-25 Published:2025-04-25

摘要:

无充气腋窝入路腔镜甲状腺手术(GUA)是甲状腺腔镜手术的重要进展,具有显著的美容效果和良好的临床疗效。本文系统评述了GUA的临床应用现状、核心技术创新、质控体系及未来发展方向。研究显示,GUA在甲状腺良性肿瘤和甲状腺癌的治疗中,手术效果与传统开放手术相当,但美容效果和病人满意度大幅提升。通过优化手术入路设计、改进建腔设备和规范操作流程,GUA显著降低术后并发症的发生率,保护颈前功能区,改善病人术后生活质量。此外,多学科协作和术前评估是手术成功的基础,术中质控措施和术后综合随访体系为手术的安全性和有效性提供了保障。未来,随着机器人技术的引入和单孔设备的更新,GUA有望在甲状腺腔镜手术中发挥更大的作用,给病人提供更微创、更美观的治疗选择。

关键词: 无充气腋窝入路腔镜甲状腺手术, 甲状腺肿瘤, 手术术式, 质量控制

Abstract:

The endoscopic thyroidectomy by gasless unilateral axillary approach (GUA) represents a significant advancement in the field of endoscopic thyroid surgery, offering notable aesthetic and clinical therapeutic benefits. This paper reviewed the current clinical application, core technological innovations, quality control systems, and future developmental directions of GUA. Research indicated that GUA achieved surgical outcomes comparable to traditional open surgery in the treatment of benign thyroid tumors and thyroid cancer, while substantially enhancing cosmetic results and patient satisfaction. By optimizing the surgical approach design, enhancing cavity construction equipment, and standardizing the operational process, GUA markedly reduced the incidence of postoperative complications, preserved the anterior cervical functional area, and improved patients' postoperative quality of life. Furthermore, multidisciplinary collaboration and thorough pre-operative evaluation were fundamental to surgical success, while intraoperative quality control measures and a comprehensive postoperative follow-up system ensured the safety and efficacy of the procedure. In the future, the integration of robotic technology and advancements in single-site devices are anticipated to enhance the role of GUA in endoscopic thyroid surgery, thereby offering patients more minimally invasive and aesthetically favorable treatment options.

Key words: Endoscopic thyroidectomy by gasless unilateral axillary approach (GUA), Thyroid tumor, Surgical technique, Quality control

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