Zuckerkandl结节在腔镜甲状腺手术中的临床意义

Clinical significance of Zuckerkandl＆#39;s tubercle in endoscopic thyroidectomy

目的 探讨腔镜甲状腺手术中Zuckerkandl结节与喉返神经和上甲状旁腺的解剖关系及临床意义.方法 对江苏省苏北人民医院2012年7月-2014年6月施行的120例腔镜甲状腺手术（至少行一侧腺叶切除）术中观察Zuckerkandl结节的有无,以及与喉返神经和甲状旁腺的解剖位置关系.通过术中辨认Zuckerkandl结节来显露喉返神经及甲状旁腺.结果 Zuckerkandl结节的出现在绝大多数病例：左侧为86％（51/59）,在右侧为88％（65/74）.喉返神经主要位于Zuckerkandl结节后方.甲状旁腺主要位于Zuck-erkandl结节的外上方.结论 Zuckerkandl结节与喉返神经和甲状旁腺之间有密切的解剖关系.在腔镜甲状腺手术中,通过术中辨别Zuckerkandl结节可以更好避免喉返神经及甲状旁腺损伤.

Objective To investigate the anatomical relation between Zuckerkandl＇s tubercle and recurrent laryngeal nerve and the superior parathyroid glands anatomy in endoscopic thyroidectomy.Methods From Jul.2012 to Jun.2014 implementation of the 120 cases of endoscopic thyroid surgery （at least one side of the line lobectomy） intraoperative Zuckerkandl tubercle of the presence, all the patients from Subei People＇s Hospital and location of the relationship between anatomy recurrent laryngeal nerve and superior parathyroid glands.Zuckerkandl tubercle identified by intraoperative recunent laryngeal nerve to expose and superior parathyroid glands.Results Zuckerkandl tubercle appear in the vast majority of cases： on the left is 86% （51/59）, 88% in the right side （65/74）, most of superior parathyroid glands were located on the top of Zuckerkandl tubercle.Looking for recurrent laryngeal nerve by Zuckerkandl tubercle method is more direct, can reduce surgical bleeding and shmten the operation time.Conclusion Recurrent laryngeal nerve and superior parathyroid glands and have close anatomical relationship with Zuckerkandl tubercle.In endoscopic thyroidectomy by intraoperative discern Zuckerkandl tubercle can better avoid injury recurrent laryngeal nerve and superior parathyroid glands.