三维B超定位图指导内镜甲状腺手术治疗结节性甲状腺肿的探讨  

Three-dimensional ultrasound locatization in endoscopic thyroidectomy for multinodular goiter

作　　者：檀谊洪[1] 杜国能[1] 肖玉根[1] 陈庞州[1] 严国标[1] 谭东兴[1] 王昆[1] 邱万寿[2] 

机构地区：[1]南方医科大学附属南海医院甲乳外科,广东佛山528200 [2]中山大学附属第三医院甲乳外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第22期1262-1264,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨在结节性甲状腺肿的内镜手术治疗中,三维B超定位图及手术技巧的意义。方法:32例结节性甲状腺肿患者施行乳晕入路内镜下甲状腺切除术,术前B超定位病灶并标记于自行设计的三维定位图上,术中从下极开始充分暴露腺体,根据定位图保留Berry韧带平面或(和)上极腺体。结果:根据B超定位单侧病变有15例,其中3例行腺叶切除术;双侧病变17例,12例行次全切除术,5例行一侧腺叶部分切除加一侧腺叶切除。无中转开放手术病例,无术后并发症,术后复查无漏切结节。结论:术前三维B超定位图及术中相应的操作技巧,有助于内镜甲状腺手术彻底的切除结节性甲状腺肿的多发病灶。Objective： To explore the three-dimensional ultrasound locatization in endoscopic thyroidectomy （ET） for multinodular goiter（MG）. Method：Thirty two patients with MG underwent ET via bilateral areolar ap- proach. Preoperative uhrasonography were used to locate lesions and marked in the 3-D map designed by us. Dur ing ET procedure, surgery skills were adopted to expose inferior pole of thyroid, glands in the area of Berry liga- ment or （and） upper pole were retained according to the preoperative location map. Result： According to the preop- erative ultrasonic orientation, 3 lobectomy were performed in 15 cases of unilateral lesions, 12 subtotal thyroidec- tomy were performed in 17 cases of bilateral lesions, and 5 patients performed unilateral lobectomy add partial thy- roidectomy. All patients had successful ET using bilateral areola approach. No conversions to open surgery, no complication occurred, and no nodules were found missing in the postoperative ultrasonography examinations. Con- clusion：Preoperative ultrasonic orientation and intraoperative operating skills are contributing to a successful ET for MG.

关 键 词：内镜甲状腺手术 超声定位 结节性甲状腺肿 

分 类 号：R615[医药卫生—外科学]