腔镜甲状腺手术喉返神经的显露技巧

Clinical experience of exposing recurrent laryngeal nerve in endoscopic thyroid surgery

目的:探讨腔镜甲状腺手术中喉返神经的显露技巧。方法:回顾分析56例腔镜甲状腺近全/全切除术的临床资料,总结腔镜手术中喉返神经的显露入路及方法。结果:53例手术获得成功,3例因术中冰冻病理报告为甲状腺乳头状癌而中转开放行患侧颈部淋巴结改良清扫术。手术时间平均125.3 min,其中23例经腺体下极入路,20例经峡部向气管食管沟入路;13例经甲状软骨下角入路。术后住院期间及出院后3个月随访,患者均无声音嘶哑。结论:腔镜甲状腺手术中剖显喉返神经是安全、可行的,可避免喉返神经损伤。

Objective：To summarize the experience of exposing recurrent laryngeal nerve（RLN） in endoscopic thyroid surgery.Methods：The clinical data of 56 endoscopic near-total or total thyroidectomy were retrospectively analyzed.The approaches and methods of exposing RLN were summarized.Results：Fifty-three cases were performed successfully,3 cases were converted due to the malignant reports of intraoperative frozen section.The mean operative time was 125.3 min.The RLNs were exposing by three approaches：inferior pole of thyroid（23 cases）,isthmus to tracheoesophageal groove（20 cases） and inferior horn of thyroid cartilage.During the 5d of hospital stay and 3 months of follow-up postoperatively no hoarseness was recorded.Conclusions：Exposing the recurrent laryngeal nerve in endoscopic thyroid surgery is safe and feasible and it can avoid the injury to RLN in endoscopic thyroidectomy.