当前研究介绍了一项通过无气体经口道途径进行en bloc切除乳头状甲状腺癌的初步探索。本研究旨在总结和探索使用无气体经口道途径进行en bloc切除甲状腺全切和双侧中央区淋巴结的疗效和安全性，针对双侧乳头状甲状腺癌患者进行试验。该研究于2021年1月至2021年12月进行，在中国科学技术大学第一附属医院使用三个气囊和四个手术器械技术，对30名患有双侧乳头状甲状腺癌的患者进行了甲状腺全切和双侧中央区淋巴结en bloc切除术。总结了手术的关键步骤和难点，并分析了患者的临床病理特征和手术并发症。所有手术均成功进行，未改为开放手术。病理诊断为双侧乳头状甲状腺癌，平均最大肿瘤直径为0.85±0.51cm(范围0.3-2.5cm)，无毛囊外包膜浸润的病例。采集的中央区淋巴结平均数量为11.36±5.36个，发现16例(53.3%)存在中央区淋巴结转移，平均1.53±2.39个。另外，12例(40%)患有淋巴细胞性甲状腺炎，五例(16.6%)患有微小的包膜浸润。所有患者术后副甲状腺激素水平正常。但是，一名患者由于反复喉神经分支受损术后声音嘶哑。该操作方案表明三个气囊和四个手术器械技术能够在不切断甲状腺峡部的情况下使用无气体经口道途径en bloc切除甲状腺全切和双侧中央区淋巴结。因此，该技术可被视为一种有效且安全的手术方法，适用于双侧甲状腺癌和外科整容需求的患者。 版权所有© 2023 Sheng，Liu，Fang，Zheng和Wang。

The current study presents a preliminary exploration of en bloc resection via a gasless transoral approach in papillary thyroid carcinoma.This study aimed to summarize and explore the efficacy and safety of en bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach in patients with papillary thyroid carcinoma.This study was conducted between January 2021 and December 2021. It involved 30 patients with bilateral papillary thyroid carcinoma who had undergone en bloc resection of the total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach using a three-trocar and four-instrument technique at The First Affiliated Hospital of the University of Science and Technology of China. The key steps and difficulties of the operation were summarized, and the clinicopathological characteristics and surgical complications of patients were analyzed.All operations were successful without conversion to open surgery. The pathological diagnosis was bilateral papillary thyroid carcinoma. The mean maximum tumor diameter was 0.85 ± 0.51 cm (range 0.3-2.5 cm). There was no case of gross capsular invasion. The mean number of harvested central compartment lymph nodes was 11.36 ± 5.36. Central compartment lymph node metastases were found in 16 patients (53.3%) with a mean of 1.53 ± 2.39. On the other hand, lymphocytic thyroiditis was observed in 12 cases (40%), and microscopic capsular invasion was observed in five cases (16.6%). All patients had normal parathyroid hormone levels after the operation. However, one patient developed hoarseness after the operation due to injury of the recurrent laryngeal nerve branch, but there was no numbness of the mandible and lower lip or infection of the oral incision.The study revealed that the three-trocar and four-instrument technique can be used in the en bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach without disconnecting the thyroid isthmus. As a result, the operation is considered effective and safe. Therefore, this technique may be a better surgical method for patients with bilateral thyroid cancer and cosmetic needs.Copyright © 2023 Sheng, Liu, Fang, Zheng and Wang.