192例经乳腔镜困难甲状腺大部切除术的技巧探讨

Discussion on technique of difficult thyroidectomy (192 cases)

摘要:

摘要：目的 探讨经乳腔镜困难性甲状腺大部切除手术方法与技巧。方法 回顾性分析2010年1月－2018年1月采取腔镜下经乳晕入路完成的困难性甲状腺大部切除手术192例，结合术者的体会和经验方法进行探讨。结果 8例因术中暴露止血困难、肿物过深过大等原因而中转开放手术；手术时间（126.8± 7.6）min，术中出血量（102.3±2.6）ml；术后18例出现一过性低钙血症和9例出现声音嘶哑（其中6例术后2个月恢复，3例术后半年仍未恢复）。结论 困难性甲状腺手术采用腔镜下经乳晕入路术式切除是安全可靠的，但必须充分掌握甲状腺的解剖结构及腔镜操作技术。

Abstract:

Abstract: Objective To discuss the operating skill of difficult thyroidectomy by endoscopic through areola. Methods Retrospective analysis of 192 cases of difficult thyroidectomy by endoscopic through areola approach from January 2010 to January 2018, combined with the surgeon’s experience. Results 8 cases were converted to open surgery because of difficulties of hemostasis during the operation and the over depth or large of the tumor, and other reasons; The average operation time was (126.8 ± 7.6) min, the mean intraoperative blood loss was (102.3 ± 2.6) ml; Transient hypocalcemia occurred of 18 cases, hoarseness occurred of 9 cases (6 cases recovered after 2 months, 3 cases have not recovered after half a year). Conclusion The difficult thyroidectomy by endoscopic through areola is safe and reliable, but the anatomy of thyroid gland and endoscopic technique must be fully mastered.