腔镜辅助甲状腺切除术中喉返神经的显露及保护  

Locating and protecting recurrent laryngeal nerve in minimally invasive video-assisted thyroidectomy

作　　者：秦建武[1] 黑虎 张松涛[1] 翟翼飞[1] 

机构地区：[1]河南省肿瘤医院头颈科,郑州 450008 [2]河南省甲状腺肿瘤研究所

出　　处：《肿瘤研究与临床》2010年第12期804-806,共3页Cancer Research and Clinic

摘　　要：目的探讨腔镜辅助甲状腺切除术（MIVAT）中喉返神经的解剖定位标志及避免神经损伤的操作技巧。方法2008年8月至2010年8月开展MIVATl06例，其中8例中转为开放手术。术中以“气管、颈动脉间隙”结合“气管外侧壁中、后份”作为解剖标志定位喉返神经。结果术中共需探测喉返神经98条，其中97条（98．98％）喉返神经通过上述解剖标志被顺利探查到，未探查到的1例为右侧非返性喉返神经；1例（1．02％）术后出现一过性喉返神经麻痹，无永久性喉返神经麻痹发生。结论在MIVAT术中，“气管、颈动脉间隙”结合“气管外侧壁中、后份”是安全有效的喉返神经解剖定位标志。Objective To study the anatomic landmarks of recurrent laryngeal nerve （RLN） in minimally invasive video-assisted thyroidectomy （MIVAT）, and to evaluate the operative skills to avoid nerve injury. Methods 106 patients were enrolled in the study dated between August 2008 and August 2010, in which 8 patients were converted to the conventional thyroideetomy. Iniraoperative anatomic landmarks for location of RLN were the gap between trachea and carotid artery （GTC）, as well as the middle and posterior portion of tracheal wall. Results 98 RLN were at risk, and 97 （98.98 %） nerves were recognized by means of two landmarks. 1 nerve failed to locate which was non-recurrent laryngeal nerve. Temporary RLN paralysis happened to 1 nerve（1.02 %）, and no permanent RLN paralysis appeared. Conclusion GTC combined with middle and posterior portion of tracheal wall are safe and effective anatomic landmarks to locate RLN in- MIVAT.

关 键 词：外科手术 微创性 甲状腺疾病 喉返神经 

分 类 号：R65[医药卫生—外科学]