经口甲状腺切除术

经口甲状腺切除术是近年发展起来的新术式。通过口腔前庭向颈部建立手术腔隙施行微创手术。适用于甲状腺良性病变以及没有侧颈淋巴结转移的甲状腺癌。优点是颈部无疤痕；手术入路相对临近；暴露良好并可以一次处理双侧甲状腺病变和中央区淋巴结。本例患者诊断为甲状腺癌，经口施行了甲状腺全切除和中央区淋巴结清扫。术中清晰暴露上位甲状旁腺并全程解剖喉返神经。利用超声刀安全稳固处理甲状腺上动脉和下动脉，失血少，术野清晰，而且术后无需置放引流管。术后并发症主要是术野区疼痛以及下唇周围麻木，通过术后镇痛和休息可以得到完全恢复。经口甲状腺切除术需要严格选择病例并由经验丰富的外科医生施行才能安全，有效。

Transoral thyroidectomy

Transoral thyroidectomy is a newly developed surgical procedures in recent years. Surgical space is established through vestibule of the mouth. This procedure is indicated for thyroid benign lesions and thyroid cancers without evident lateral cervical metastasis. Its advantages include scarless neck; relative near surgical route; good exposure and treatment of bilateral thyroid glands with central compartment dissection simultaneously. This case was diagnosed as thyroid cancer and received transoral total thyroidectomy with central compartment neck dissection. During the operation, superior parathyroid glands and the recurrent laryngeal nerve were clearly exposed and protected. Harmonic scalpel was used to safely and stably cut off superior and inferior thyroid arteries with less blood loss and clear surgical field. No drainage tube was needed in this procedure. The postoperative complications mainly included pain and para-lower lip numbness, which could recover from appropriate rest and application of postoperative analgesic. Transoral thyroidectomy is a safe and effective surgical procedures only if rigid selection of cases and surgeons with rich experiences are guaranteed.