内镜下甲状腺手术的临床应用研究

The clinical application study of thyroidectomy with endoscopic

目的:探讨经腋窝或胸前壁入路,内窥镜下完成甲状腺疾病手术治疗的可行性。方法:41例,年龄21～42岁。甲状腺腺瘤32例(单侧27例,双侧5例),结节性甲状腺肿9例(单侧5例,双侧4例)。于腋窝或胸前壁切口,并建立皮下隧道至甲状腺,内窥镜下应用超声刀切除病灶。结果:32例采用经腋窝入路,9例采用经胸前壁入路,全部镜下完成甲状腺手术。手术时间1h15min～5h35min,平均2h5min。术中出血,经腋窝入路平均45ml,经胸入路平均95ml,未出现手术并发症。结论:内窥镜下甲状腺手术是安全可靠的一种新方法。超声刀可以处理甲状腺的任何血管。

Objective To find the feasibility of thyroidectomy starting from armpit or breast by endoscopic.Method In41cases,the age from21to42years old,32cases were thyroid adenoma (27cases were simple side of nodular goiter and5cases were double sides)and9cases were nodular goiter(5cases were simple side of nodular goiter and4cases were double sides).Cut at armpit or breast,establish channels under skin to thyroid gland and remove the focus applying ultrasonic scalpel with endoscopic.Results32cases adopt apply the armpit-beginning operation and9cases adopt the breast-beginning operation with endoscopic completely,the respective opera-tion consume a minimum of 1hour and15minutes,a maximum of 5hours and35minutes.Average time was2hours and5min utes.Average blood loss was45ml in the armpit-beginning operation,and average blood loss was95ml in breast-beginning operation.There were not any complications.Con clu sion Thyroidectomy with endoscopic is a new secure method.For the magnifying of endoscopic and illuminating of cold light.The operating field becomes clearer so that ultrasonic scalpel can deal with any blood vessel of thyroid gland.