73例腔镜下甲状腺叶切除术的体会  

Clinical experinces of endoscopic thyroidectomy in 73 cases

作　　者：师天雄[1] 邓建伟[1] 谭焕东[1] 

机构地区：[1]广东中山市人民医院普外科,广东中山528403

出　　处：《中国内镜杂志》2007年第2期138-140,144,共4页China Journal of Endoscopy

摘　　要：目的探索利用腔镜行甲状腺手术的方法、适应证及价值。方法用腔镜为73例甲状腺腺瘤、甲状腺囊肿、结节性甲状腺肿、乔本氏甲状腺炎、甲状腺功能亢进及甲状腺癌的病人实施了经胸入路甲状腺手术。结果全部病例手术成功,前39例平均手术时间(160±32)min;后34例平均手术时间(85±13.3)min。术后住院时间(4±0.5)d。暂时性声嘶2例,暂时性呛咳2例,皮下积液1例。未发生术后出血,无中转开放手术。术后恢复良好,近期随访颈部皮肤感觉接近正常。结论腔镜行甲状腺手术具有无颈部疤痕、美容效果好、恢复快等优点。对适应证明确者,应该是值得推崇的手术方式。[Objective] To further evaluate the clinical application of video assisted endoscopic thyroidectomy. [Methods] Thyroidectomy with endoscopic instruments through chest-wall approach was done for 73 patients from July 2002 to December 2004. The age of the patients was from 16 to 53 years old （mean 33）. Three trocars were placed above both nipples and at the point of between nipples respectively. Subcutaneous space was built between nipples and neck. CO, was inflated at the pressure of 6 mmHg, Dissection of thyroid, division and homeostasis of vessels and parenchyma and resection of thyroid was all done by using ultrasonically act/vate scalpel with adenoma; cyst; multiple nodes and cancer of thyroid. [Results] All 73 cases of operation were successful with no conversion. 18 patients experienced bilateral subtode lobe thyroidectomy, The others had unilateral subtotle lobeetomy or partial lobectomy. Pathologically there were 32 cases of poiter, 27 cases of adenoma, 5 cases of papillary cancer, 2 cases of hyperthyroid, 6 cases of cyst, 1 case of Hashimoto disease. There were no severe surgical complications such as nerve damage or hemorrhage, average operation duration was （160±32） rain for the former 39 cases and （85±13.3） rain for the current 34 cases. The mean time of hospitalization after operation was （4±0.5） days. [Conclusions] With the advantages of minimal and hidden incision, sooner recovery and satisfactory cosmetic effect, The endoscopic thyroidectomy will prevail in selected cases in the future.

关 键 词：腔镜 甲状腺部分切除术 甲状腺疾病 

分 类 号：R581[医药卫生—内分泌]