腔镜甲状腺切除术并发症的防治(附169例报告)

Prevention and Treatment of Postoperative Complications in Laparoscopic Thyroidectomy (Experience of 169 Cases)

目的 探讨腔镜甲状腺切除术后并发症的防治经验。 方法 对 169例患者施行腔镜甲状腺切除术 ,总结本类手术术后并发症的危险因素及防治措施。 结果 共 163例患者成功施行腔镜甲状腺切除术 ,6例中转开放手术。共出现 11例并发症 :脂肪液化 2例 ,皮下气肿 1例 ,皮肤淤斑 2例 ,术后头痛2例 ,一过性声音低钝 1例 ,一过性声音嘶哑 2例 ,术后甲状腺危象 1例 ,未发现复发及死亡。 结论 腔镜甲状腺切除术有其特殊并发症 。

Objective To discuss the prevention and therapy of postoperative complications of laparoscopic thyroidectomy. Method Based on experience of 169 cases of laparoscopic thyroidectomy from March 2002 to April 2003, the risk factors, occurrence, prevention and therapy of the postoperative complications were discussed. Result Only 6 cases were reversed to open surgery, while the laparoscopic thyroidectomy of all the other 163 cases were successfully finished. The following postoperative complications were found in 11 cases including fat colliquation in 2, pneumohypoderma in 1, skin silt patch in 2, postoperative headache in 2, temporary vocal dullness or hoarsness in 3, and postoperative thyroid crisis in 1. No relapse or death were observed. Conclusions Laparoscopic thyroidectomy can be accompanied by certain complications. However, accurate operative skills and careful perioperative procedure can decrease the occurrence rate of the complications.