完全腔镜甲状腺手术328例体会

【摘要】〓目的〓探讨完全腔镜下甲状腺手术的可行性及术中避免神经损伤及甲状旁腺损伤的方法。方法〓采取完全乳晕入路、前胸壁入路及乳沟入路完成腔镜下甲状腺切除术手术328例。结果〓328例手术成功,无中转开放手术。术后有2例甲状旁腺损伤,出现麻木及抽搐,给予钙剂治疗后恢复;5例喉返神经麻痹,出现声音嘶哑,给予理疗好转,平均恢复时间1~4个月,1例术后出现分离间隙淤血,后经穿刺抽液三次后愈,胸前水肿一个月后消褪。术后患者均自述有术区麻木感,1~3个月后自行消除。全部患者对切口美容效果满意,术后随访1~30个月,无复发。结论〓完全腔镜下甲状腺手术是一个安全有效的手术方法,在心理微创与美容效果有明显的优势。

Experiences with complete endoscopic thyroidectomy in 328 cases

Objective To report the experience of thyroid surgery under complete endoscope. Methods From Nov. 2008 to Feb. 2010, 328 patients underwent thyroidectomy with the single- incision complete endoscopic surgery technique via the anterior chest wall approach,cleavage and areola of mammary gland incision. An experience of operation was summarized and reported. Results 328 surgical performances were successfully completed ,without transferring and open surgery. Five cases hand transient recurrent laryngeal nerve paralysis, recovering after 1 to 4 months. Parathyroid injury occurred in two cases with transient numb and mild tetany. Incision hematoma happened in one case. No additional surgery was performed. The patients were followed up for 1 to 30 months with satisfactory results. All patients were satisfied with the cosmetic effects of the operation. Conclusion Complete endoscopic thyroidectomy is feasible and practicable.