完全腔镜治疗甲状腺功能亢进的经验和手术技巧

Experience and Skills in SET for Hyperthyroidism

甲状腺功能亢进(甲亢)最常见的是原发性甲亢(Graves病,GD)。颈部无疤痕腔镜甲状腺手术(SET)在治愈甲亢的同时具有良好的美容效果。SET的适应证同开放手术相似。无美容要求的患者是SET的绝对禁忌证。SET的相对禁忌证包括既往有甲状腺手术史或甲状腺腺体体积超过130ml等。为防止术后复发,我们选择全切或者尽可能少的保留背侧部分甲状腺,一般保留4g^6g甲状腺组织。我们常用的手术入路是胸乳入路或全乳晕入路。减少术中出血是手术成功的关键,只有具备丰富腔镜经验的甲状腺专科医生,才能胜任GD的SET手术。

Graves＇ disease is the most common form of hyperthyroidism. Scarless in the neck endoscopic thyroidectomy （SET） is feasible and safe with excellent cosmetic results for selected cases. The indication of SET is similar to that of conventional open procedure. The patients of no cosmetic requirements is an absolute contraindication of SET. SET relative contraindications include a history of thyroid surgery or thyroid gland volume of more than 130ml and so on. To prevent recurrence, we chose full cut or keep as little as possible the dorsal part of the thyroid gland, usually reserved 4g ~6g thyroid tissue. The surgical approach we used is chest-breast road or areola road. It is important to reduce bleeding intraoperatively. Rich experience in endoscopic surgery is essential for thyroid surgeons to perform SET.