逆行性甲状腺腺叶切除术（附162例）

目的:初步探讨甲状腺腺叶切除术的新方法。方法:自2012年1月-2014年1月采用自内向外、自下向上逆行解剖的方法进行甲状腺腺叶切除162例。结果:所有病例均获成功。手术时间(96±18.3)min，术中出血量(26±15.7)ml。术后病理:结节性甲状腺肿97例，微小乳头状癌42例，腺瘤性甲状腺肿17例，腺瘤4例，桥本氏病2例。无术后出血、呼吸困难、呛咳、手足抽搐等并发症。3例术后出现暂时性声音嘶哑，经恢复治疗后发音正常。2例切口下方切缘I°烫伤，1例II°烫伤，后在手术中用凡士林纱布保护切口下缘，再无上述情况发生。随访时间6-30个月，平均随访15个月，均无复发，美容效果满意。结论:逆行性甲状腺腺叶切除术是可行和安全的，特别适用于经中线小切口或者腔镜辅助下行甲状腺腺叶切除，可作为甲状腺外科的一种新方法。

Retrograde thyroid lobectomy (162 cases)

Objective:To explore a new retrograde method for thyroidectomy.Methods:Appling a retroanotomy method from interior to lateral and from bottom to top to perform the thyroidectomy for 162 patients.Results:The new method was successfully performed in all 162 patients.The mean operation time was (96±18.3) min and the intraoperative blood loss was (26±15.7) ml.In the final pathology,there were 97 nodular goiter,42 papillary thyroid microcarcinoma,17 adenomatous goiter,4 follicular adenoma and 2 Hashimoto disease.There was no postoperative homorrhage,dyspnea,bucking and hypocalcemia.Transient recurrent laryngeal nerve injury was 3 and restored after healing treatment.2 patients suffered first-degree burns and 1 second-degree burns,then no patient got burned after protecting the inferior edge of incision by petrolatum gauze.All patients were followed-up for 6 to 30 months,mean follow-up 15 months.No recurrence happened and cosmetic effects were satisfied.Conclusion:The retrograde thyroid lobectomy is a safe and feasible operation for thyroid surgical treatment,especially for small incision and video-assisted thyroidectomy.