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1996年Gagner[1]率先将腔镜技术应用于甲状旁腺手术,自此开创了腔镜手术的新天地。此后许多外科医师尝试从不同径路完成腔镜甲状腺手术,如腋窝入路、乳晕入路、前胸壁入路等[2～9]。2001年,Yamamoto等[10]将乳晕径路甲状腺手术用于治疗Graves病;2002年Ikeda等[11～13]报道应用前胸部径路和腋窝径路治疗甲状腺结节、良性或低级的滤泡性病损和Graves病。目前,腔镜技术适用于良性甲状腺疾病已获得广泛认可,但是许多外科医师仍不满足于此,尝试在腔镜下完成甲状腺的完整切除,进而可将其推广应用于甲状腺癌的手术治疗中[6]。2002年,Miccoli等[7]首次报道对一例甲状腺乳头状癌的病人成功施行了腔镜辅助下甲状腺次全切除术。
In 1996, Gagner [1] took the lead in applying endoscopic surgery to parathyroid surgery, and has since created a new world of endoscopic surgery. Since then, many surgeons have attempted to perform endoscopic thyroid surgery from different pathways, such as armpit approach, areola approach, anterior chest wall approach, etc. [2-9]. In 2001, Yamamoto et al [10] used areola-pathologic thyroidectomy for the treatment of Graves’ disease. In 2002, Ikeda et al. [11-13] reported the treatment of thyroid nodules, benign or inferior follicular lesions using anterior thoracic and axillary approaches Graves disease. Currently, the endoscopic technique for benign thyroid disease has been widely recognized, but many surgeons are still not satisfied with this attempt to complete a complete removal of the thyroid under endoscopy, which can be extended to the surgical treatment of thyroid cancer [ 6]. In 2002, Miccoli et al. [7] reported for the first time that a case of thyroid papillary carcinoma was successfully treated with endoscopic subtotal thyroidectomy.