颈前小切口内镜甲状腺手术63例探讨

Study of 63 cases with minimally invasive video-assisted thyroidectomy

目的探讨小切口无气工作腔室内镜下甲状腺手术的临床应用可行性及效果。方法颈前单一2cm小切口径路,借助外牵吊技术建立无气工作腔室。以高频超声刀剪作为主操作器械,辅以特选吸引剥离器等,对63例甲状腺占位病人实施内窥镜下手术。结果61例手术均获成功。2例因出血失控转为开放手术,6例因冰冻病理证实为甲状腺癌而转为开放手术。结论颈前小切口无气腔室内镜下甲状腺手术是安全、可靠、有效的方法。

Objective To study the feasibility and the effect of minimally invasive video-assisted thyroidectomy. Methods A gasless working space was created with conventional retractor through 2cm small incision on neck. Sixty-three cases of adenomas and nodular goiters consecutively received the endoscopic operation. The procedure was designed to use ultrasonic scalpels and scissors as major instruments, and suction-detacher or others as supplementary instruments throughout the whole process. Results The operations in 61 cases were successfully finished, 2 of them were interrupted to open surgery due to uncontrollable bleeding, 6 of them were converted to open surgery due to thyroid carcinoma. Conclusion The operation is safe, feasible and effective.