内镜甲状腺切除术的手术要点

目的：探讨应用内镜外科技术施行甲状腺手术的可行性及手术要点。方法：采用颈部无疤痕内镜甲状腺切除术(SET)和微创电视辅助甲状腺切除术(MIVA)。SET切口选择在乳晕上缘、胸骨旁，钝性游离胸前和颈前皮下腔隙，在内镜下行甲状腺肿瘤切除或腺体次全切除术。MIVA切口选择在胸骨切迹上1cm处，长约3cm，在电视辅助下行甲状腺肿瘤切除或腺体次全切除术。结果SET、12例和MIVA 12例全部手术成功，术后恢复良好，无声嘶、呛咳等并发症，颈部水肿隆起明显改善。结论：内镜下甲状腺切除术是可行的，SET具有明显的美容效果，MIVA是一种微创和有效的方法，手术应由有内镜外科经验的医师进行，关键在于良好的显露和止血。

Key Points in Endoscopic Thyroidectomy

Objective To study the feasibility and experiences of thyroidectomy by using endoscopic technique. Methods SET incisions were made on the anterior part of the breast and areola, blunt dissection of the subcutaneous planes of the neck and chest was administered. MIVA incisions were made 1 cm above the suprasternal notch and the operation was video assisted in the thyroid adenoma extripation and subtotal thyroidectomy.The thyroid nodules were extirpated or subtotal thyroidectomy was performed. Results All 12 cases of the SET and 12 cases of the MIVA were successfully performed without complications. Conclusions The endoscopic thyroidectomy is feasible. SET has a good cosmetic effect. MIVA causes minimal trauma but is effective. The key of operation is the skill of the doctors and the clear exposure of the operation field.