胸骨后甲状腺肿物32例外科治疗

目的：探讨胸骨后甲状腺肿物的手术入路及方法。方法：良性甲状腺肿物采用颈部低领式切口入路,按甲状腺切除的方法给予处理;胸骨后甲状腺乳头状癌,采用颈部低领式切口加颈部正中纵切口,行肿瘤姑息切除加气管切开术。结果：31例良性甲状腺肿物患者采用颈部切口入路均获成功;1例甲状腺乳头状癌患者采用颈部纵切口,姑息切除肿瘤加气管切开,术后追加放疗及同位素治疗,生存期超过5年。32例患者中,9例（28．1％）出现并发症;5例（15．6％）出现喉返神经损伤;出血3例（9．4％）。结论：颈部低领式切口是切除胸骨后甲状腺良性肿瘤的理想入路,恶性肿瘤手术径路有待进一步探讨。

Surgery of substernal thyroid goiter:32 cases reported

OBJECTIVE: To probe into the surgical approaches and operative techniques for substernal thyroid goiter. METHOD: In the way with operating on thyroid retrosternal thyroid tumour were removed via cervical collar incision and substernal thyroid cancer was partly removed via "perpendicular" shape cervical incision and tracheotomy. RESULT: The operations via cervical collar incision on 31 cases with substernal thyroid goiter have been carried out successfully. One thyroid cancer was partly moved via "perpendicular" shape cervical incision and tracheotomy, radiation therapy and isotope was adopted after operation, the patient survived above 5 years. Syndrome occurred in 9 cases (28.1%); recurrent laryngeal nerve were damaged in 5(15.6%), hemorrhage in 3(9.4%). CONCLUSION: Resection via cervical collar incision for all retrosternal thyroid nodules was advised and surgery for malignancy needs to be investigated.