内镜甲状腺切除术  

The experience in laparoscopic thyroidectomy

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

机构地区：[1]卫生部中日友好医院普外二科,北京100029

出　　处：《中华普通外科杂志》2009年第12期969-972,共4页Chinese Journal of General Surgery

摘　　要：目的探讨内镜甲状腺切除术的手术难点和应对策略。方法对169例患者施行内镜甲状腺切除术，总结本类手术难点、危险因素及防治措施。结果内镜甲状腺切除手术成功167例，包括甲状腺腺瘤切除术37例，甲状腺单叶大部分切除术63例，甲状腺双叶大部分切除术42例，甲状腺功能亢进行甲状腺双叶次全切除术20例，甲状腺癌行甲状腺单叶并峡部全切除对侧次全切除术5例。无神经或甲状旁腺损伤等严重并发症。中转开放手术2例，术后切口脂肪液化2例，皮下气肿1例，皮肤淤斑1例，一过性声音嘶哑1例，随访1～4年，复发1例，无死亡病例。结论内镜甲状腺切除术有其特殊的操作方法和手术难点，通过精细的术中操作和适当的围手术期处理可以降低副损伤的发生率。Objective To discuss the operative difficulties and management in laparoseopic thyroidectomy. Method The clinical data of 169 cases undergoing laparoscopic thyroidectomy were retrospectively analyzed. Result Among 169 cases, only 2 cases were switched to open surgery. Among the other 167 cases local thyroidectomy for thyroid adenoma was performed in 37 cases, one side subtotal thyroideetomy in 63 cases, two side subtotal thyroidectomy in 42 cases, laparoscopic subtotal thyroidectomy was done in 20 cases for Grave＇s disease, and radical thyroidectomy was undertaken in 5 cases of thyroid carcinoma. Postoperatively fat colliquation occurred in 2 cases, pneumohypoderma, skin bruise and temporary vocal dullness or hoarsness in 1 each case. There was no postoperative recurrent laryngeal nerve injury, nor that of the parathyroid gland. Conclusions Laparoscopic thyroidectomy has its own intraoperative difficulties. Accurate operative skills and careful perioperative management can decrease the occurrence of complications.

关 键 词：甲状腺切除术 甲状腺疾病 手术后并发症 

分 类 号：R653[医药卫生—外科学] R736.1[医药卫生—临床医学]