非颈部切口内镜甲状腺手术的技巧  

Key technique in endoscopic thyroidectomy through anterior chest and breast approach

作　　者：鲁瑶[1] 王文跃[1] 刘海滨[1] 刘军[1] 彭维朝[1] 孟凡强[1] 介建政[1] 周雷[1] 马仁[1] 李启东[1] 李胜利[1] 刘治滨[1] 

机构地区：[1]中日友好医院普外二科,北京100029

出　　处：《中日友好医院学报》2009年第4期198-200,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨内镜技术在非颈部切口甲状腺手术中应用的技术难点及处理技巧。方法:回顾分析中日友好医院普外二科2006年10月～2008年7月128例经胸乳途径内镜甲状腺手术患者的临床资料。结果:128例中122例成功,6例中转手术。手术时间48～240min,平均85min。术中平均出血15ml。颈部引流管术后3d拔除,平均术后4d出院。手术未损伤喉上神经、喉返神经及甲状旁腺。122例随访6～9个月,无一例术后肿瘤复发。所有患者对术后切口满意。结论:非颈部切口内镜甲状腺手术出血少、并发症低,是一种颈部无瘢痕、安全可靠的新方法。手术的关键技巧在于手术操作空间的建立、甲状腺及肿瘤的良好显露、超声刀的运用以及出血的处理。Objective：To investigate the key technique difficulities and its managements in endoscopic thyroidectomy through anterior chest and breast approach.Methods：A retrospective analysis was made on the clinical data of 128 cases,who were treated from Oct 2006 to July 2008 in China-Japan Friendship Hospital. Results：One hundred and twenty-two cases of 128 operations were successfully performed.Six cases was converted to conventional thyroidectomy.The operation lasted 48-240 minutes（mean 85 minutes） , and the intraoperative average blood loss was 15ml.The drainage tube was removed at day 3 and discharged from the hospital on 4th day after operation.There was no complication such as the injury of the recurrent laryngeal nerve and parathyroid gland.No recurrence was found in 122 cases after 6-9 months following up.All patients were satisfied with the cosmetic resuhs.Conclusion：Endoscopic thyroideetomy is safe and feasible with favourable cosmetic effect.The key technique of operation are keeping the adequate handling space,clear exposure of the thyroid gland and management of bleeding.

关 键 词：甲状腺肿瘤 甲状腺手术 内镜 并发症 

分 类 号：R653[医药卫生—外科学]