免气腹局麻下电刀法经胸前腔镜甲状腺切除术16例报告

目的:探讨免气腹局麻下电刀法经胸前腔镜甲状腺切除术的可行性、安全性和优越性。方法:免用CO2气体及全麻,首创颈丛麻醉加胸前壁局麻,应用电钩、双极电凝钳及剪刀经胸前途径,在腹腔镜下行单侧或双侧甲状腺局部或次全切除术。结果:6例双侧甲状腺多发囊肿患者行甲状腺次全切除术,平均手术时间120min,术中平均出血35ml;4例单发结节性囊肿和6例甲状腺瘤患者行肿物切除术,平均手术时间65min,术中平均出血20ml,1例术中甲状腺组织弥漫性出血中转开放,术后1例声音嘶哑,理疗半月缓解,无头晕、呕吐等并发症发生,术后平均住院3.5d。结论:免气腹局麻下电刀法经胸前腔镜甲状腺切除术安全可行、美观、简便、经济。避免了CO2气体造成的相关并发症。

Laparoscopic thyroidectomy via anterior chest wall approach with hook electrode,non-pneumoperitoneum,local anesthesia:a report of 16 cases

Objective:To explore the value,safty and feasibility of laparoscopic thyroidectomy via anterior chest wall approach with hook electrode,non-pneumoperitoneum,local anesthesia.Methods:Under neck plexus block and anterior chest wall infiltration anesthesia,16 cases were performed local or subtotal laparoscopic thyroidectomy with hook electrode,bipolar coagulation grasper and scissors via anterior chest wall approach.Results:Subtotal laparoscopic thyroidectomy was accomplished in 6 cases with multiple thyroid c...