镜下甲状腺手术无重大并发症发生的经验

目的总结预防镜下甲状腺手术并发症的经验. 方法双侧病变12例经前胸入路,单侧病变41例经腋下入路,用自制的器械做从切口到甲状腺的皮下隧道,宽约5 cm,充CO2压力4 mm Hg,用腹腔镜器械与超声刀完成病灶的分离、切除.结果腺瘤41例(单侧34例,双侧7例),结节性甲状腺肿12例(单侧7例,双侧5例).术后1例出现皮下隧道血肿,保守治愈,无神经损伤及甲状旁腺并发症发生.结论超声刀及持续系统低腔隙压是预防并发症有效方法.

Experience on the prevention of severe complications of endoscopic thyroidectomy

Objective To summarize the experience on the prevention of severe complications of endoscopic thyroidectomy.Methods Twelve cases of bilateral lesions underwent endoscopic thyroidectomy via precordial approach and 41 cases of unilateral lesions, via subaxillary approach. A subcutaneous channel, with a width of about 5 cm from the incision site to the thyroid, was made by using self-made instruments. The CO 2 pressure was set at 4 mm Hg. By ultrasonic scalpel the lesions were divided and removed. Results There were 41 cases of thyroid adenoma (unilateral, 34 cases; bilateral, 7 cases) and 12 cases of nodular goiter (unilateral, 7 cases; bilateral, 5 cases). Postoperative subcutaneous hematoma occurred in 1 case and was cured by conservative management. No nerve damage or parathyroid complications were observed. Conclusions Application of ultrasonic scalpel and continued low cavity pressure are effective means for preventing complications in endoscopic thyroidectomy.