[1]向国安,陈开运,王汉宁,等.腔镜甲状腺手术98例报告[J].中国微创外科杂志,2006,06(9):678-680.
　Xiang Guoan,Chen Kaiyun,Wang Hanning,et al.Endoscopic surgery for thyroid diseases: Report of 98 cases[J].Chinese Journal of Minimally Invasive Surgery,2006,06(9):678-680.
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腔镜甲状腺手术98例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
06
期数:
2006年9期
页码:
678-680
栏目:
出版日期:
2006-09-20

文章信息/Info

Title:
Endoscopic surgery for thyroid diseases: Report of 98 cases　
作者:
向国安; 陈开运; 王汉宁; 高鹏; 马周和; 郑权; 肖方联; 肖金丰; 谭敏①
广东省第二人民医院微创中心,吴阶平医学基金会-诺道夫微创外科培训中心,广州,510317
Author(s):
Xiang Guoan;  Chen Kaiyun;  Wang Hanning;  et al.
Department of General Surgery, Second People’s Hospital Guangdong Province, Guangzhou 510317, China
关键词:
甲状腺疾病; 腔镜
Keywords:
Thyroid disease; 　Endoscope
分类号:
R653
文献标志码:
A
摘要:
目的 探讨2种不同途径腔镜甲状腺手术的价值.方法 2003年12月～2005年8月,我院行腔镜甲状腺手术98例,采用经乳晕、胸骨前三孔法(胸壁途径)或双侧腋窝三孔法(腋窝途径),通过分离胸前皮下和颈阔肌深面,注入CO2(压力8～10 mm Hg)建立手术操作空间.超声刀切割、分离甲状腺组织和甲状腺血管;术中保护喉返神经、喉上神经以及甲状旁腺.1例行一侧腺叶切除及对侧甲状腺部分切除手术,18例行一侧腺叶切除术,12例行双侧甲状腺次全切除手术,46例行一侧腺叶次全切除术,21例行甲状腺肿块切除术.结果 98例手术均获成功,无一例中转开放手术,无手术并发症.手术时间(69.1±29.0) min,术中出血量(37.9±10.6) ml,术后住院(3.5±0.7) d.颈部引流管术后24～36 h 拔除.2例甲状腺癌随访24个月,未见复发;余96例随访6～28个月,平均16个月,无复发.结论 经胸壁及腋窝途径行腔镜甲状腺手术具有极佳的美容效果,可以作为一种治疗手段对有特别要求的患者应用. 　
Abstract:
Objective　To investigate the clinical value of two kinds of endoscopic thyroidectomy for thyroid diseases.　 M ethods　Endoscopic thyroidectomy via breast approach or axillary approach was performed in 98 cases from December 2003 to August2005. The subcutaneous space beneath the breastarea and the subplatysmal space in the neckwere bluntly dissected through a 5-mm incision. The CO2was insufflated at the pressure of8~10mmHg to create an operative space. Three trocarswere inserted. The dissection of the thyroid parenchyma and vessels was performed endoscopically by using an ultrasonically activated scalpe.l The recurrent laryngeal nerve, the superior laryngeal nerve, and the parathyroid glands were preserved carefully. There were 1 case of lobectomy on one side and partial thyroidectomy on the other side, 18 cases of unilateral lobectomy, 12 cases of bilateral subtotal thyroidectomy, 46 cases of unilateral subtotal lobectomy, and 21 cases of resection of thyroid mass.　Results　The operation was successfully completed in all the 98 cases, without conversions to open surgery. No complicationswere noted. The operative timewas 69. 1±29. 0 min, the estimated blood losswas 37. 9±10. 6 m,l and the postoperative hospital staywas 3. 5±0. 7 days. The drainage tubewas removed at24~36 hours after operation. Two cases of thyroid cancerwere followed for 24 monthswithout recurrence. The remaining 96 cases were followed for 6 ~ 28 months (mean, 16 months) without recurrence.　Conclusions　Endoscopic thyroidectomy via breast or axillary approach is feasible and safe, giving patients satisfactory cosmetic results.

参考文献/References:

[1]陈德兴,董加纯,赵淑清,等.内窥镜下甲状腺手术的临床应用.中国微创外科杂志,2002,2:319-321.
[2]Huscher CS,Chiodin S,Napolitano C,et al.Endoscopic tight thyroid lobectomy.J Surg Endosc,1997,11:877-878.
[3]陈平康,孙春雷,徐志成.颈腔镜甲状腺手术.中国微创外科杂志,2002,2(增刊):S96.
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备注/Memo

备注/Memo:
①（中山大学附属第一医院微创中心,广州,510000）
更新日期/Last Update: 2014-02-13