腔镜下甲状腺手术并发症的防治体会

目的探讨腔镜下甲状腺手术并发症的特点及防治方法。方法回顾性分析105例腔镜下甲状腺手术的临床效果和并发症发生情况。结果105例平均手术时间85min，因出血转开放手术5例，因术中病理为乳头状癌转开放手术11例。术后皮下淤血5例，皮下气肿10例，颈部及胸前皮肤发紧不适7例，甲状旁腺损伤2例。105例均无喉上、喉返神经损伤。结论在严格控制手术适应证的前提下，熟练细致的腔镜操作技巧，熟悉甲状腺的解剖结构，术后并发症的及时、妥善处理，可以减少和预防并发症的发生。

Experience on the prevention and treatment of endoscopic thyroidectomy complications

Objective To understand the characteristics of complications occurred after endoscopic thyroidectomy and its prevention and treatment. Methods Retrospective analysis on the clinical effects and complications of 105 cases of endoscopic thyroidectomy. Results The average operative time was 85 minutes in the 105 cases. Five cases were transferred to open operation because of bleeding and 11 cases transferred for the intraoperative pathology of papillary carcinoma. After operation, subcutaneous ecchymosis occurred in 5 patients, subcutaneous emphysema in 10 cases, neck and anterior chest skin tautness and discomfort in 7 cases, parathyroid injury in 2 cases. No superior laryngeal nerve or recurrent laryngeal nerve injury was found in the 105 cases. Conclusion Under strict control on operation indications, proficient and meticulous endoscope operative skills, familiarization with the anatomical structure of thyroid, and timely and proper treatment on postoperative complications can reduce and prevent the occurrence of complications.