腔镜下双侧甲状腺次全切除术治疗轻中度甲亢(附6例报告)

目的:总结腔镜下甲状腺次全切除术治疗轻中度甲亢的手术方法及应用价值。方法:回顾分析2012年3月至2012年7月为6例患者经胸乳入路行腔镜甲状腺手术的临床资料。结果:5例顺利完成腔镜甲状腺手术,1例因合并桥本甲状腺炎术中出血量较多中转开放手术。手术时间83～180 min,平均(125.8±16.9)min;术中出血量30～145 ml,平均(75.5±8.8)ml。术后1例出现一过性喉返神经麻痹,未予特殊处理,两周后好转。术后无出血、呼吸困难、手足麻木、甲亢危象等严重并发症发生。结论:严格把握手术适应证,积累腔镜甲状腺手术经验,术中仔细操作,腔镜甲状腺次全切除术治疗甲状腺功能亢进是安全、可行的。

The treatment of mild-to-moderate hyperthyroidism by endoscopic bilateral subtotal thyroidectomy:with a report of 6 cases

Objective:To summarize the methods and clinical value of endoscopic subtotal thyroidectomy for mild-to-moderate hyperthyroidism.Methods:The clinical data of 6 patients who underwent endoscopic subtotal thyroidectomy via trans-thoracoareolar approach from Mar.2012 to Jul.2012 were retrospectively analyzed.Results:The operations in 5 cases were successful.One case was converted to open operation for combination of hashimoto thyroditis and large amounts of hemorrhage.The operative time was from 83 min to 180 min,average(125.8±16.9) min.Intraoperative blood loss was from 30 to 145 ml,average(75.5±8.8) ml.Temporary recurrent laryngeal nerve paralysis occurred in one case,and recovered two weeks after operation without special treatment.No other severe complications such as postoperative bleeding,dyspnea,hand and foot numbness or hyperthyroidism crisis occurred.Conclusions:Endoscopic subtotal thyroidectomy for mild-to-moderate hyperthyroidism is safe and feasible in the condition including strictly selected indications,rich surgical experiences and careful operation.