改良Miccoli术式内镜下甲状腺手术667例分析  

Skills of endoscopic thyroidectomy via small incision of neck:an analysis of 667 cases

作　　者：陈光[1] 董愫[2] 刘嘉[1] 孟伟[1] 孟宪瑛[1] 王贵民[1] 

机构地区：[1]吉林大学第一医院甲状腺外科,吉林长春130021 [2]吉林大学第一医院麻醉科,吉林长春130021

出　　处：《中国实用外科杂志》2010年第11期952-954,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨腔镜辅助下颈部小切口甲状腺手术(Miccoli术式)中的技巧,总结手术各项指标及相关经验。方法回顾性分析2006年6月至2010年4月吉林大学第一医院甲状腺外科667例腔镜辅助下颈部小切口行甲状腺手术的临床资料。结果 667例均顺利完成腔镜辅助甲状腺手术。前50例手术平均时间(60±13)min;后617例平均(39±9)min。术中出血量15～80mL,术后引流量5～35mL,均于第2天拔除引流管。术后住院时间(3±1)d。手术切口长2.0～2.5cm。术后均未使用止痛药,出现暂时性声嘶1例,皮下气肿1例,中转开放手术10例。所有病例均未发生术后出血或感染。全组随访3～12个月,无一例复发。结论腔镜辅助下颈部小切口甲状腺手术安全可靠、并发症少且美容效果相对较好,在掌握一定技巧的基础上实施,临床效果更佳,应用前景广阔。Objective To explore the skills of endoscopic thyroidectomy via small incision of neck and summarize the indexes and experiences about the operations. Methods The clinical data of 667 cases underwent endoscopic thyroidectomy via small incision of neck between June 2006 and June 2009 at the First Hospital of Jilin University were analyzed retrospectively. Results The operations of 667 cases were all successful. The mean operation time of the former 50 cases and the after 617 cases were （60± 13）minutes and （39±9）minutes respectively. The blood loss in operation was 15-80mL. The volume of drainage after operation was 5-35mL. The drainage tubes were all pulled out in the second day. The time of postoperative hospitalization was （3 ± 1 ）days. The size of the incision was 2.0-2.5cm. The patients were all satisfied with the sear. No analgesic was acquired after the operation. There were 1 ease hoarse, 1 ease cutaneous emphysema, 6 cases open operation. There was no haemorrhage or infection in all eases. No one recurred after the following 3-12 months. Conclusion After acquiring certain skills, endoscopic thyroideetomy via small incision of neck is safe and reliable and offers better cosmetic results.

关 键 词：甲状腺切除术 腔镜 

分 类 号：R6[医药卫生—外科学]