甲状腺功能亢进患者行乳晕入路腔镜下甲状腺手术的技巧探讨

Techniques of endoscopic thyroid surgery for patients with hyperthyroidism

摘要:

目的 探讨乳晕入路腔镜下甲状腺手术治疗甲状腺功能亢进的操作技巧。方法 回顾性分析该院34例甲状腺功能亢进患者的病例资料，对手术情况及术中出血和腺体切除的方式进行分析。结果 该组病例无中转手术，手术时间（128.9±28.6）min，术中出血量（75.3±28.4）mL，术后2例出现甲状旁腺激素（PTH）降低，术中腺体血管出血200 mL以上者6例（17.6%），腺体分块切除27例（79.4%）。结论 腔镜手术治疗甲状腺功能亢进难度较大，术中要控制出血，医师需掌握操作技巧，通过一定数量病例学习曲线的练习，才可保障手术的成功。

Abstract:

Objective To investigate the feasibility and saftey of endoscopic surgery for hyperthyroidism.Methods 34 patients with hyperthyroidism performed with endoscopic surgery were retrospectively reviewed, then analyze the operative process, the volume of intraoperative hemorrhage and method of gland excision.Results There was no patients switching to open surgery in this group. The operation time was (128.9 ± 28.6) min, the volume of intraoperative blood loss was (75.3 ± 28.4) mL. There were 6 (17.6%) patients whose blood loss more than 200 mL and 2 (5.9%) patients developed parathyroid hormone. Glandular segmentation was adpoted in 27 (79.4%) patients.Conclusion Carefully handling with the intraoperative bleeding and mastering the skills of glandular segmentation through learning curve, endoscopic surgery could be safe for hyperthyroidism.