内镜辅助甲状腺手术中喉上神经保护

Protection of superior laryngeal nerve in video-assisted endoscopic thyroid surgery

目的探讨内镜辅助甲状腺手术中对喉上神经保护的技巧。方法对我院2006年10月~13年4月共650例实施内镜辅助小切口甲状腺手术的患者进行回顾性病例分析和总结。结果所有患者均成功完成手术,术后绝大部分患者对切口外观的满意。有8例（1.23%）患者出现暂时性喉上神经损伤,无一例永久性喉上神经损伤。结论内镜辅助小切口甲状腺手术是一种新型的手术方式,需要术者掌握一定的手术技巧,可有效降低术后并发症,避免永久性喉上神经损伤和降低暂时性喉上神经损伤发生率。

OBJECTIVE To investigate the technique of protection of superior laryngeal nerve in endoscopic thyroid surger y. METHODS From Oct. 2006 to April 2013, the clinical data of 650 patients with thyroid diseases underwent endoscopic thyroidectomy viacervic alsingle smallincision we r e a n a ly z e d retrospectively. RESULTS Operations were successfully performed in 650 cases. Most patients were very satisfied with postoperative incision appearance. There was no permanent superior laryngeal nerve injury occurred after operation, but 8 cases（1.23%）occurred temporary superior laryngeal nerve injury. CONCLUSION Single incision endoscopic thyroid operation is a new type of operation. The surgeon must master some surgical skills, including building operation space technique, cooperating with other equipment, operational manual skills, and application of ultrasonic knife and so on. Mastering these skills is useful to reduce the postoperative complications, and can effectively avoid permanent superior laryngeal nerve injury and reduce temporary superior laryngeal nerve injury.