改进法甲状腺叶切除术(附360例报告)

Modified thyroid lobectomy:360 cases report

目的探讨以避开喉上神经、显露喉返神经和保留甲状旁腺的改进法甲状腺叶切除术为主体的甲状腺手术的可行性。方法对2004年12月至2009年6月广东省人民医院普通外科完成的360例改进法甲状腺叶切除术为主体的甲状腺手术的全部临床资料进行回顾性分析。结果在根治病变的基础上,共完成360例411侧改进法甲状腺叶切除术为主体的甲状腺手术,最大限度地保留了甲状腺功能,喉返神经显露率达100%,共保留甲状旁腺543个(平均每侧腺叶1.32个),术后无一例出现喉上神经、喉返神经和甲状旁腺损伤相关并发症。结论改进法甲状腺腺叶切除术为主体的甲状腺手术能最大限度保留甲状腺功能、降低手术相关并发症发生率、减少术后复发。

Objective To explore the feasibility of thyroid surgery mainly composed of modified thyroid lobectomy with the purpose of averting superior laryngeal nerve,exposing recurrent laryngeal nerve and preserving parathyroid gland. Methods This retrospective review analyzed the clinical data of 360 cases of thyroid surgery mainly composed of modified thyroid lobectomy in Guangdong Provincial People’s Hospital from Dec 2004 to June 2009. Results 360 cases of thyroid surgery including 411 sides of modified thyroid lobectomy was performed on the basis of eradicating lesion,thyroid function was preserved to the greatest extent, exposing rate of recurrent laryngeal nerve was 100%, a total of 543 parathyroid glands was preserved （average 1.32 parathyroid gland per lobe）,no relative complications such as injuries of superior laryngeal nerve,recurrent laryngeal nerve and parathyroid gland were followed. Conclusion Thyroid surgery mainly composed of modified thyroid lobectomy might preserve thyroid function to the greatest extent,decrease all kinds of complications relating to thyroid surgery,and reduce postoperative recurrence.