腔镜甲状腺手术53例报告

A Report of 53 Cases of Endoscopic Thyroidectomy

目的探讨腔镜甲状腺手术并发症的防治技巧。方法我院2008年1月～2013年1月采用胸骨前人路游离皮瓣，行甲状腺大部切除术53例。结果单侧甲状腺大部切除术23例，双侧甲状腺大部切除术29例。术中出血5～100ml，平均15．6ml；手术时间30～170min，平均53min；术后2～3d拔除引流管；住院时间3～9．5d，平均4．5d。1例出现暂时性甲状旁腺功能低下，表现为手足麻木，口服钙剂及维生素D，1周后恢复。1例有颈前紧束感，加强功能锻炼后症状缓解。46例随访6个月-5年，平均19．6月，未见复发。结论合理的操作空间，精准的细节操作，确切的止血是防治腔镜甲状腺手术并发症的关键。

Objective To explore the skills for preventing complications in endoscopic thyroid surgery. Methods Fifty-three patients underwent endoscopic subtotal thyroidectomy via anterior sternal approach in our hospital from January 2008 to January 2013. Results Among the 53 patients, unilateral subtotal thyroidectomy and bilateral subtotal thyroidectomy were carried out in 23 and 29 cases, respectively. The mean blood loss was 15.6 ml （range, 5 -100 ml） and the mean operative time was 53 rain （range, 30 - 170 min）. The mean hospital stay was 4.5 d （ range, 3 - 9.5 d） and the drainage tubes were removed 2 to 3 days after operation. Temporary parathyroid dysfunction occurred in one patient with the symptom of numbness and the patient recovered one week after taking oral calcium and vitamin D. Anterior tightness appeared in one patient and the symptom was alleviated through exercise. No recurrence was found in 46 cases during the follow-up of 6 months to 5 years （ average, 19.6 months）. Conclusion The key to complication prevention in endoscopic thyroidectomy is sufficient operating space, experienced operation skills and exact hemostasis.