从开放超声刀甲状腺手术向腔镜甲状腺手术的过渡

The application of using ultrasonically activated shears in miniscarf thyroid surgery to laparoscopic thyroid surgery

目的探讨从颈部开放切口的超声刀甲状腺手术向腔镜甲状腺手术过渡的应用价值,以及超声刀热效应对手术的影响。方法在完成颈部开放切口的超声刀甲状腺手术50例前、后分别进行腔镜甲状腺手术3例和18例。结果颈部开放切口的超声刀甲状腺手术之前的腔镜甲状腺手术,手术时间190～300min,术中出血90～350ml,手术种类为甲状腺病灶的局部切除以及甲状腺单叶的次全切。完成颈部开放切口的超声刀甲状腺手术50例之后进行的腔镜甲状腺手术,手术时间70～120min,术中出血5～30ml,未出现手术并发症,手术种类增至甲状腺腺叶全切以及双侧次全切等。结论掌握开放切口的超声刀甲状腺手术可以明显缩短腔镜甲状腺手术的学习曲线,增加手术安全性。

Objective To investigate the application of using ultrasonically activated shears(UAS) in miniscarf thyroid surgery to laparoscopic thyroid surgery and the influence of UAS to surgery.Methods 3 and 18 cases were preformed laparoscopic thyroid surgery respectively before and after 50 cases were preformed miniscarf thyroid surgery by using UAS.Results To laparoscopic thyroid surgery,the mean operation time before miniscarf thyroid surgery by using UAS was 190～300mins(70～120mins,after),the mean intraoperation bleeding minisscarf thyroid surgery by using UAS was 90～350ml(5～30ml,after),the kinds of operation in front of miniscarf thyroid surgery by using UAS were ablation and focal of one part thyroid(radical operation in one part or two parts thyroid,after).Conclusion Mastering the operation of miniscarf thyroid surgery by using UAS can obviously reduce the time to master the operation of laparoscopic thyroid surgery,it can increase operation security.