腹腔镜辅助小切口甲状腺结节手术的临床应用

Minimally invasive laparoscopic.assisted surgery of the thyroid nodule

目的探讨腹腔镜辅助小切口甲状腺手术的微创性、可操作性、实用价值和经验。方法2006年1月至2008年8月．在黑龙江省医院普外科选择56例甲状腺结节患者，肿块最大5．0cm×4．2cm，最小3．5cm×2．0cm．取胸骨切迹上1．0cm处做小切13，长约1．5～2．0cm，在腹腔镜辅助下用超声刀进行单侧甲状腺部分切除术20例，次全切除术25例，一侧甲状腺次全切除＋对侧部分切除术1例，双侧甲状腺部分切除术10例。结果56例手术均顺利完成，手术时间50～146min，无并发症发生。病理结果除1例甲状腺癌外，均为良性病变。结论对于大多数良性甲状腺疾病，腹腔镜辅助小切口甲状腺手术是一种创伤较小、有一定美容效果、相对容易掌握、易于推广且有效的手术治疗方法。

Objective To study the feasibility, superiority and experience of minimally invasive laparoscopicassisted surgery of the thyroid using ultrosonic scalpel. Methods In a period from January, 2006 - August, 2008, 56 patients of the department of general surgery, the hospital of Heilongjiang Province were diagnosed as thyroid node. The size of the nodes ranged from 5.0 cm × 4.2 cm to 3.5 cm×2.0 cm in ultrosonography. An incision of about 1.5 - 2.0 cm was made 1.0 cm above the suprasternal notch and the operation was performed with uhrosonic scalpel assisted with laparoscope. Partial thyroidectomy of lateral thyroid was performed in 20 cases, subtotal thyroidectomy in 25 cases, subtotal thyroidectomy of unilateral thyroid and partial thyroidectomy of contralateral thyroid respectively in 1 case, partial thyroidectomy of bilateral thyroid in 10 cases. Results All 56 cases have undergone minimally invasive laparoscopic-assisted surgery successfully in 50 - 146 min and no complications occurred. Fifty five cases were confirmed to be benign lesion pathologically. Conclusion Laparoscopic-assisted surgery of the thyroid is an effective with a good cosmetic result.