气管前入路手术路径在腹腔镜甲状腺手术中的应用

目的探讨腹腔镜甲状腺手术中的路径方法,以降低手术操作难度,减少并发症。方法对104例甲状腺疾病患者采用气管前入路手术方法施行腹腔镜甲状腺切除手术,先切断甲状腺峡部,继而切断管前筋膜、外侧韧带、悬韧带,甲状腺松动,再切断血管,根据病变决定甲状腺切除的多少。结果本组患者手术均获成功,手术平均时间105（85-195）min,平均出血量25（5-115）ml,平均住院时间4．5（3-6）d。2例二次患者术后出现轻微喉返神经麻痹症状,经观察分别于术后3、6个月后自行恢复,无永久．眭喉返神经损伤。结论气管前入路手术方法使腹腔镜甲状腺切除手术容易操作,同时减少手术并发症,是一种安全简捷的手术方法。

Anterior approach of tracheal path in laparoscopic thyroidectomy

Objective To investigate the laparoscopic procedures for thyroidectomy, and to reduce the operation difficulties and postoperative complications. Methods One hundred and four patients with thyroid disorders were given laparoscopic thyroidectomy. Firstly the isthmus was cut off, and then prctracheal fascia, the lateral ligament and the suspended ligament, and at last the blood vessel were cut off to dismiss the thyroid. Results All the operations were successful. The average operation time was 105 （85-195） min, blood loss 25 （5-115） ml, and mean postoperative hospital stay was 4.5 （3-6） days. A slight laryngeal nerve paralysis occurred in two patients for a second surgery, but disappeared 3 and 6 months after the operation respectively. Conclusion Laparoscopic thyroidectomy becomes easy for the anterior approach of tracheal path and postoperative complications reduce.