颈侧方切口甲状腺手术的步骤及要点

The steps and key points of thyroid surgery with lateral cervical incision

颈侧方切口甲状腺手术采用颈侧方切口,利用胸锁乳突肌胸骨头与锁骨头肌间的天然解剖间隙作为入路,从带状肌与颈动脉鞘之间进入甲状腺术区,首先辨识喉返神经及上下位甲状旁腺,离断上极血管,再分离Berry韧带,离断峡部,最后切除甲状腺。该手术可以避免传统手术对颈前区皮肤肌肉组织的创伤,患者术后颈部压迫感和吞咽牵拉感明显缓解。颈侧方切口甲状腺手术操作快捷,临床效果良好。本文介绍如何规范化地操作及手术注意事项等,以期更好普及推广。

The thyroid surgery with lateral cervical incision uses the sternocleidomastoid intermuscular approach through the gap between band muscles and carotid sheath to reach the surgical field. The recurrent laryngeal nerve and upper and lower parathyroid glands are first identified, the upper pole vessels are severed;then the Berry ligament is separated;the isthmus is severed, and the thyroid gland is finally removed. This approach can avoid the trauma of the skin and muscle tissue in the anterior neck region, to relieve the pressure on the neck and swallowing stretch feeling for patients after surgery. The surgical modality is effective and less time-consuming. This article gives a detailed introduction to the standardized procedures and some key points of thyroid surgery with lateral cervical incision.