胸骨前内镜下甲状腺手术喉返神经损伤的预防

Protection of recurrent laryngeal nerve in endoscopic thyroidectomy through the upper part of sternum

目的:探讨胸骨前内镜下甲状腺手术预防喉返神经损伤的方法。方法:对46例甲状腺疾病患者行胸骨前内镜下甲状腺手术,腺瘤切除和甲状腺部分切除术未暴露喉返神经,而大部或次全切除术则暴露喉返神经。结果:45例在内镜下顺利完成手术,1例为甲状腺癌中转开放手术。均无大出血、喉返神经损伤、手足麻木等严重并发症发生。结论:严格选择病例,掌握内镜下暴露喉返神经的时机和方法,可以减少喉返神经的损伤。

Objective： To study the methods of protecting recurrent laryngeal nerve （RLN） in endoscopic thyroidectomy through the upper part of sternum, Methods： The clinilica data of 46 cases underwent endoscopic thyroidectomy through the upper part of sternum was analyzed. RLN was revealed when we performed nodulectomy or partial thyroidectomy. But during subtotal and near-total thyroidectomy the RLN was always revealed. Results.. Forly-five of forty-six cases were compeleted successfully with endoscopic thyroidectomy. One case was converted to open thyroidectomy because of thyroid carcinoma. No intraoperative or postoperative hemorrhage, RLN injuried and deadlimb occurred. Conclusion： In order to reduce the injury of RLN, we should select the fitting cases strictly, master the opportunity and methods of revealed RLN.