低领小弧形切口在甲状腺腺叶切除加峡部切除术中的应用  

Minimally invasive low-collar incision in hemithyroidectomys with isthmus resection

作　　者：刘宝国[1] 王斌[1] 陈荣锐[1] 李明强[1] 王建军[1] 张乃嵩[1] 魏巍[1] 于文斌[1] 孙俊勇[1] 

机构地区：[1]北京大学临床肿瘤学院头颈科,北京100036

出　　处：《中华临床医师杂志（电子版）》2007年第4期40-42,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的观察低领小弧形切口对一侧甲状腺肿物行患侧腺叶切除加峡部切除术，能否达到术中术野显露充分、手术安全、手术时间短、术后切口低小及美学效果好的效果。方法采用2～4cm低领小弧形切口对293例一侧甲状腺肿物患者行患侧腺叶切除加峡部切除术。结果293例患者手术过程顺利，术野、喉返神经及甲状旁腺显露充分，手术时间平均51．4min（最短30min，最长80min），术中出血量平均15ml（最少5ml，最多80m1），术后切口均一期愈合，5—7d出院。切口低小且易被衣领遮盖，美学效果较好。所有患者经随访2个月～5年，均未见肿瘤复发。结论甲状腺单侧肿物采用低领小弧形切口施行单侧腺叶切除加峡部切除具有术野显露充分，手术时间短，手术安全，术后切口低小易被衣领遮盖，美学效果好的优点，较适合中青年女性。Objective Neck surgery is one of the newest fields of application of minimally invasive surgery. We developed a technique for minimally invasive thyroid lobeetomy with isthmus resection. Methods The procedure was accepted by 293 patients with a nodule of the lobe of the thyroid. We performed hemithyroideetomys with isthmus resections through a 2 -4 cm low-collar horizontal skin incision by conventional instrumentation. Results The incision provided excellent cosmetic results because the little and lower incisions were completely hidden by clothing collar. The recurrent laryngeal nerve and the parathyroid glands were easily identified and preserved. Mean operation time was 51.4 minutes （ range 30 to 80）. No complication occurred. The mean bleeding amount was 15 ml （minimum 5 ml, maximum 80 ml）. Mean postoperative stay was 5.5 days （ range 5 to 7 ）. Conclusions We concluded that our technique is feasible,safe,minimally invasive,less time consuming and cosmetically. This makes us optimistic about the future of minimally invasive surgery.

关 键 词：甲状腺切除术 外科手术 微创性 治疗方法 

分 类 号：R736.1[医药卫生—肿瘤] R653[医药卫生—临床医学]