非颈部切口内镜甲状腺手术的临床应用.pdfVIP

14 10 Vol14, No10 2009 10 JOURNAL OF LAPAROSCOPIC SURGERY Oct. 2009 : 1009- 6612( 2009) 10- 0765- 03 * , , , , , , , , , , , (, , 100029) : 探讨内镜技术用于甲状腺手术的可行性技术难点及解决方法: 回顾分析 2006年 10 月至 2008年 7月我 为 128例患者行内镜甲状腺手术的临床资料: 128例中122例内镜手术成功, 6例中转手术, 其中2例为 度甲 亢, 颈部操作空间不够; 4 例游离甲状腺肿瘤时引起难以控制的出血手术时间 48 ~ 240m in, 平均 85m in术中平均出血 15m l颈部引流管术后3d拔除, 术后4d出 6例皮下积液, 2例皮下气肿, 2例皮下瘀斑, 2例颈部感觉减退, 3例吞咽不适, 经对症处理很快康复未损伤喉上神经喉返神经及甲状旁腺随访 122例 6~ 9 个月, 无一例复发患者对术后美容效果非 常满意: 内镜甲状腺手术出血少, 并发症发生率低, 具有颈部无瘢痕美容效果极佳安全可靠的优点操作空间的建 立, 手术视野甲状腺及肿瘤的良好显露, 残留甲状腺体积的正确估计, 超声刀的熟练运用, 出血的处理及颈前肌群的熟练缝 合是手术的关键 甲状腺肿瘤; 甲状腺切除术; 内窥镜检查; 并发症 : R653 : A The c lin ical app licat ion of endoscop ic thyroid surgery w ithou t cervica l in cision LU Yao, WANG Wen-yue, LI UH ai-bin, etal.D ep t. of the Second GeneralSurgery, hina-Japan Friendshpi Hosp ita,l B eijing 100029, h ina A bstract Objec tive: T o investi ate the feasib ility, key technique d ifficu lties and its solution of endoscopic thyroidectomy throu h an terior chest and breast approach. M ethods: A retrospective analy sis w as m ade on the clin ical data of 128 cases, who w ere treated w ith endoscopic thyroidectomy from Oct. 2006 to Ju.l 2008. And the safety, ind ication, contraind ication, the key technique diff-i culties and its m ana em en t of the operation were discussed. R esults: Of 128 cases, operations were successfu lly perform ed in 122 cases and 6 cases w ere converted to conventional thyroidectom y because of 4 cases of hem