内镜甲状腺手术的临床应用

目的：探讨内镜甲状腺手术的临床应用方法。方法：采用经胸骨前路径内镜甲状腺手术治疗24例甲状腺良性肿瘤病人，并评估其临床应用价值。结果：23例顺利完成内镜甲状腺手术；其中1例因术中快速病理诊断为乳头状甲状腺癌而追加常规甲状腺癌根治术。平均手术时间150min。术中平均出血量30ml。2例出现皮下气肿，4例出现胸部皮肤麻木。无喉返神经及甲状旁腺损伤、术后出血、甲状腺危象等并发症出现。随访l、6月，所有病人对手术美容效果非常满意，未发现症状及肿瘤复发者。结论：内镜甲状腺手术是一种美容效果确切的手术方法，手术操作空间的建立和术中控制出血是该术式的两大关链技术。

CLINICAL APPLICATION OF ENDOSCOPIC THYROIDECTOMY

Objective:To study the application methods of endoscopic thyroidectomy by anterior chest approach.Methods:The data of 24 cases of endoscopic thyroidectomy by ant erior chest approach were summarizde, and the applicated value was appraised. Results:All cases were successfully performed by endoscopic thy roidectomy. One of them was diagnosed by pathologic sections and converted to ro utine thyroidectomy. The average operative time was 150 minutes;intraoperative b l ood loss was 30ml. There were 2 cases with pneumohypoderma and 4 cases with numb ness of skin of anterior chest. All patients recovered without complication such as injury of recurrent laryngeal nerve or parathyroid, postoperated hemorrhage and thyroid crisis. Followed up from 1 to 6 months, no scars were apparent in t he neck, and all patients were fully satisfied with the cosmetic results, and th ere were no recurrence of symptom and neoplasm.Conclusions:The endoscopic thyroidectomy by anterior chest app roach fully showed the advantages of cosmetic results, the creation of operated spatial and control of hemorrhage were its important techniques.