腔镜辅助小切口甲状腺手术技巧探讨

The Skills of Single Small Incision Video-Assisted Thyroid Operation

目的探讨腔镜辅助小切口甲状腺手术的手术技巧。方法回顾性分析在2006-10/2013-09月在作者医院对610例实施腔镜辅助小切口甲状腺手术的患者。结果 610例均成功完成手术。术后颈前感觉异常减退、吞咽不适、24 h疼痛很少发生。绝大部分患者对切口外观的满意度较高。术后出现4例颈部皮下血肿,5例暂时性喉返神经损伤,5例暂时性甲状旁腺功能减退。结论腔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,包括建腔技术、器械配合、操作手法、超声刀使用技巧等。掌握了这些技巧后,可降低术后并发症的发生率,缩短手术时间,使手术难度下降。腔镜辅助小切口甲状腺手术是一种具有安全、微创、美容特点的手术方式,手术变通性好,容易被患者接受,是一种值得在临床上推广的手术。

Objective To explore the skills of single incision video-assisted thyroid operation.Methods The clinical data of 610 thyroid disease patients who received single incision video-assisted operation in our hospital from October 2006 to September 2013 were analyzed and summarized retrospectively.Results Operations were successfully performed in610 cases.The jugular hypesthesia,discomfort at swallowing and the 24 hours pain after operation occurred infrequently.Most patients were very satisfied with the incision.There were 4 cases with neck subcutaneous hematoma,5 case with temporary recurrent laryngeal nerve injury and 5 case with temporary hypoparathyroidism after operations.There was no statistical significance in complications after operation between the video-assisted operation and the traditional operation.Conclusion Single incision video-assisted thyroid operation is a new type of operation.The surgeon must master some surgical skills,including building operation space technology,cooperating with other equipments operational manual skills,the use of ultrasonic knife and so on.Mastering these skills are useful to reduce the incidence of complications after operation,shorten the operation time,make the operation simple.Single small incision video-assisted thyroid operation is a kind of safe,minimally invasive,aesthetic operation method,which has good operation flexibility,easily received by patients and worthy to promote in the clinical surgery.