自制皮下分离棒在腔镜甲状腺手术中的应用

The application of self-made dissection stick in endoscopic thyroidectomy

目的 :探讨自制皮下分离棒在腔镜甲状腺手术中的应用价值。方法 :回顾分析 135例腔镜甲状腺手术的临床资料。包括甲亢 2 4例 ,甲状腺癌 3例 ,甲状腺腺瘤 30例 ,结节性甲状腺肿 78例。结果 :132例手术均获成功 ,平均手术时间 12 3min ,术中平均出血 2 0 1ml,术后 4 ～5d出院 ,中转手术 3例。 4 1例用强生公司产的塑料分离棒 ,皮下空间分离时间 4 0 8(30 ～6 5 )min ,出血 2 0 5 (1～80 )ml,1例损伤皮肤 ,多数病例分离较深 ,损伤肌肉 ,术野欠清。 94例用自制分离棒 ,皮下分离时间 11 5 (10 ～2 5 )min ,出血 2 4 (0 ～10 )ml ,无皮肤损伤 ,大多数分离层次清楚 ,术野清晰。结论 :自制分离棒在皮下分离过程中缩短了手术时间 ,减少了出血。

Objective:To evaluate the value of self-made dissection stick in endoscopic thyroidectomy.Methods:The clinical data of 135 cases including 24 cases of thyroidism and 3 cases of thyroid carcinoma and 30 cases of thyroid adenona and 78 cases of nodulav goiter,who were undergone endoscopic thyroidectomy(ET) were analyzed.Results:132 cases of ET were successfully performed,whose mean operative time was 123 minutes and mean blood loss was 20.1ml.They were in hospital for 4-5 days after operation.3 cases were converted into open thyroidectomy.41 cases were operated with Johnson & Johnson's plastic dissection stick,whose mean time for subcutaneous dissection was 40.8(30-65)minutes and mean blood loss 20.5(1-80)ml.Skin penetration was found in one case which recovered quite well after the operation.The dissection layer was too deep in most of the cases in which muscles were damaged.94 cases were operated with the self-made dissection stick,whose mean time for subcutaneous dissection was 11.5(10-25)minutes and mean blood loss 2.4(0-10)ml.Conclusions:The self-made dissection stick helps to shorten the subcutaneous dissection time and reduce bleeding.