胸骨上入路完全腔镜下甲状腺手术的应用研究

摘要

目的 探讨胸骨上入路完全腔镜下甲状腺手术的安全性及技术要点.方法 于2002年10月到2009年12月对57例甲状腺良性病变施行胸骨上入路完全腔镜下甲状腺手术.其中结节性甲状腺肿30例,甲状腺腺瘤15例,甲状腺囊肿12例.结果 所有手术均获成功,手术时间为90～180min,无中转开放手术.术后无大出血、声音嘶哑、手足抽搐等严重并发症发生.随访6～18个月无复发,颈部仅留微小疤痕,美容效果满意.结论 胸骨上入路完全腔镜下甲状腺手术是一种安全、微创、美容的手术方法.手术有效操作空间的建立、超声刀的正确使用以及熟练的腔镜操作技巧是手术成功的重要保障.%Objective To explore the safety and technique difficulties of endoscopic thyroidectomy via the superior of sternum. Methods From October 2002 to December 2009, 57 patients with benign thyroid diseases underwent endoscopic thyroidectomy via the superior of sternum, including 30 eases of nodular goiter, 15 eases of thyroid adenoma, 12cases of thyroid cyst. Results 557 eases were completed successfully without complication such as bleeding or damage of nerve and parathyroid gland. The operative time was ranged from 90 to 180 min. No recurrence was found in 57 eases after 6-18 months following up. All the patients were satisfied with the cosmetic result. Conclusion Endoscopic thyroidectomy via the superior of sternum is a safe, mini-invasive, convenient way.Keeping the adequate handling space, applying the ultrasound knife correctly and having good endoscopic technique are essential to perform endoscopic thyroidectomy successfully.