免充气腔镜甲状腺手术的进展  

Progression in gasless endoscopic thyroidectomy

作　　者：戴孟桥 郜小妮 李蓁珥 谢洋[2,4] 刘家锋 应勇 曾祥泰[2,3,4] DAI Meng-qiao;GAO Xiao-ni;LI Zhen-er;XIE Yang;LIU Jia-feng;YING Yong;ZENG Xiang-tai(Postgraduate students of Grade 2020,Gannan Medical University;Department of Thyroid and Hernia Surgery,The First Affiliated Hospital Of Gannan Medical University;Institute of Thyroid Diseases,Gannan Medical University;Ganzhou Key Laboratory of Thyroid Tumor,Ganzhou,Jiangxi 341000)

机构地区：[1]赣南医学院第一临床医学院 [2]赣南医学院第一附属医院甲状腺疝外科 [3]赣南医学院甲状腺疾病研究所 [4]赣州市甲状腺肿瘤重点实验室,江西赣州341000

出　　处：《赣南医学院学报》2023年第4期419-423,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市科学技术局课题(GZ2019ZSF029)。

摘　　要：过去十年,为了减少颈部瘢痕和降低手术并发症,越来越多的微创甲状腺手术和免充气腔镜甲状腺手术在许多国家开展。本文回顾了免充气腔镜甲状腺手术的发展历史和最新进展。随着免充气手术器械的发展,经腋窝入路、胸乳入路、双乳入路、耳后入路、经口前庭入路等免充气腔镜甲状腺手术近年来相继被报道。免充气腔镜甲状腺手术患者不仅可避免高碳酸血症、空气栓塞和皮下气肿等并发症,还可以减少手术时间。总之,免充气腔镜甲状腺手术是可行的,最显著的优点是其安全性和美观性,缺点是目前还缺乏统一标准的器械。因此,我们需要掌握免充气腔镜甲状腺手术的优势和局限性,为每位患者选择最佳入路的免充气腔镜甲状腺手术。To minimize neck scarring and reduce complications,minimally invasive thyroidectomy and gasless endoscopic thyroidectomy have been developed in many countries over the past decade.This article reviews the development of gasless endoscopic thyroid surgery and recent advances.With the development of different instruments to built and maintain the surgical space,the gasless endoscopic thyroidectomies such as transaxillary approach,chest-breast approach,bilateral breast approach,postauricular approach,and transoral vestibular approach were reported in recent years.The complication of hypercapnia,air embolism and subcutaneous emphysema could be avoided and operative time is significantly shorter in patients undergoing the gasless endoscopic thyroidectomy.In conclusion,gasless endoscopic thyroidectomy is feasible,the most significant advantage of gasless endoscopic thyroidectomy is its safety and cosmesis,and the disadvantage is lack of standard instruments.Therefore,it is necessary to understand these advantages and limitations of gasless endoscopic thyroidectomy,and to select the appropriate approach for each patient.

关 键 词：甲状腺手术 腔镜 免充气 手术入路 

分 类 号：R616.2[医药卫生—外科学]