无注气甲状腺内镜外科手术

Endoscopic thyroid gland surgery without carbon dioxide neck insufflation

目的 初步评价无注气的内镜甲状腺外科手术的可行性。方法 对16例甲状腺肿物的患者分别采用颈前悬吊方法和胸骨柄上方2-3 cm水平切口进行甲状腺内镜外科手术,年龄23-62岁,其中甲状腺瘤6例,结节性甲状腺肿10例。2例采用锁骨下入路,14例采用胸骨柄上小切口入路,全部内镜下完成甲状腺手术,其中甲状腺腺叶切除术8例,甲状腺次全切除术7例,峡部加双侧腺叶部分切除术1例。结果 内镜下利于显露和识别喉返神经和甲状旁腺,手术时间为1.1-4.0 h,无并发症,术后的美观效果好。结论 无注气内镜下甲状腺外科手术技术是可行和安全的,可作为甲状腺外科的一种新术式。

Objective To evaluate endoscopic thyroid gland surgery without carbon dioxide neck insufflation. Methods Sixteen patients with thyroid gland benign tumor, aged from 23-62years, were selected and treated with endoscopic surgery. Eight cases received whole thyroid lobectomy and the other eight cases received partial thyroid lobectomy, the procedure was through a wall method or a single 2. 0-3. 0 cm horizontal skin incision. Among the 16 cases, 6 were thyroid adenoma and 10 were nodular goiter. Results All patients received endoscopic surgery, 2 cases with sub-clavicle approach and 14 cases with a single 2. 0-3. Ocm horizontal skin incision approach. The recurrent laryngeal nerve and parathyroid glands were easily identified and preserved during operation, the operating time lasted from 1. 1 hours to 4. 0 hours, no complication occurred, the postoperative cosmetic outcome was excellent. Conclusions The results indicated that gasless technique is feasible and safe, so it suggested that the video-assisted thyroid surgery without carbon dioxide neck insufflation could be an alternative for thyroid gland surgery.