腔镜甲状腺手术中甲状旁腺保护的研究进展

Research Progress of Parathyroid Protection in Endoscopic Thyroidectomy

甲状腺疾病发病率不断升高,外科手术目前仍是治疗甲状腺疾病的最重要手段。随着人们对美容需求的增加和腔镜甲状腺技术的不断成熟,腔镜甲状腺手术的适应证已逐渐由良性疾病扩展到早期甲状腺癌。虽然已取得了较好的临床效果,但如何在术中正确地识别保护甲状旁腺及其血供,避免术后甲状旁腺功能减退仍是困扰外科医师的一大难题。对于外科医师来说,不仅要有扎实的解剖基础,熟悉甲状旁腺的正常位置及变异,还应掌握腹腔镜下甲状旁腺的特征,准确识别及保留。另外,配合使用腔镜器械及正负显影技术可以帮助医师识别甲状旁腺,值得推广使用。

The incidence of thyroid diseases is increasing year by year. Surgery is still the most important method for the treatment of thyroid diseases.With the increasing demand for cosmetology and the maturity of endoscopic thyroidectomy,the indications of endoscopic thyroidectomy have gradually expanded from benign diseases to early thyroid cancer,and good clinical results have been achieved.However,how to correctly identify and protect the parathyroid gland and its blood supply in order to avoid hypoparathyroidism after operation is still a difficult problem for the surgeons.Surgeons should not only have a solid anatomical basis and be familiar with the normal location and variation of parathyroid glands,but also grasp the characteristics of parathyroid glands under laparoscopy and accurately identify and retain them.In addition,the use of endoscopic devices and positive and negative imaging technology can help surgeons to identify parathyroid glands, which is worth promoting.