腔镜甲状腺手术近期并发症的原因分析和防治

Causes, prevention and therapy of short-term complications of endoscopic thyroidectomy

目的总结腔镜甲状腺手术近期并发症的发生原因和防治经验。方法回顾性分析实施腔镜甲状腺手术患者的近期并发症的可能因素。结果 2010年8月至2013年12月,86例经胸或经乳晕入路的腔镜甲状腺大部或次全切除术,12例患者发生一种或几种近期并发症,发生率13.95%。术后近期并发症:皮肤灼伤1例,皮下气肿5例,皮下血肿2例,胸骨上窝积液3例;残留甲状腺结节1例;暂时性声音嘶哑1例;颈、胸皮肤粘连发紧4例;血栓性浅静脉炎3例。12例并发症患者经相应处理后均痊愈。结论腔镜甲状腺手术近期并发症的发生与手术技巧和围手术期处理有关;把握好手术适应证,熟练的腔镜技术和丰富的开放手术经验是减少和避免近期并发症发生的关键。

Objective To summarize the cause, prevention and therapy of short-term complications of endoscopic thyroidectomy. Methods The risk factors of short-term complications of the patients underwent endoscopic thyroidectomy were retrospectively reviewed. Results Eighty six patients underwent endoscopic thyroidectomy through the approach approach of chest-wall or areola papillaris from August 2010 to December 2013.Of these patients 12 have different kinds of postoperative complications with a complication incidence rate of 13.95 %.One patient had skin burn, 5 did hypodermic emphysema,2 did hypodermic gore,3 did subcutaneous fluid collection in suprasternal fossa,1 did leftover of small nodes in thyroid,1 did transient hoarseness,4 did neck and chest skin tight and 3 did superficial thrombophlebitis.All patients with the postoperative complication were cured by conservative therapies.Conclusions The short-term postoperative complications of endoscopic thyroidectomy are usually correlated with operative skill and the treatment of perioperative period; Strict operation indication,expert endoscopic technique and open operation experience is the key to reduce and avoid the incidence of short-term postoperative complications.