摘要
目的探讨颈前皮瓣悬吊(免充CO2气体)建立皮下手术空间,进行胸乳入路腔镜甲状腺手术的临床价值。方法对21例甲状腺疾病,其中结节性甲状腺肿16例、原发性甲状腺功能亢进(甲亢)5例,利用腹壁悬吊器,采用2根悬吊针机械牵拉的方法悬吊颈前部皮瓣形成手术空间完成甲状腺切除手术。结果21例手术均成功完成,无中转开放手术。手术时间57～125min,平均82.5min,术中出血<20ml。术后恢复顺利,引流量50～150ml,平均80.6ml。21例随访1～12个月,平均8个月,无并发症发生。结论颈前皮瓣悬吊免充CO2气体胸乳入路甲状腺手术避免术中充注CO2气体所引起的相关并发症,吸引水雾方便,手术空间较充气法稍小,但基本不影响手术的进行,是一种安全可行而经济的手术方法。
Objective To study the benefits and drawbacks of endoscopic thyroidectomy via breast approach by using gasless anterior neck skin lifting method. Methods A total of 21 patients with thyroid diseases were enrolled in this study, including 16 cases of nodular goiter and 5 cases of primary hyperthyroidism. All the cases underwent endoscopic subtotal thyroidectomy through breast approach while the operational space was established by using an abdomen suspending device and 2 Kirschner pins to mechanically suspend and retract the anterior neck skin. Results The endoscopic subtotal thyroidectomy was completed successfully in all of the cases without conversion to open surgery. The mean operation time was 82.5 minutes （ranging from 57 to 125 minutes）. Intraoperative blood loss was less than 20 ml. Post-operational recovery was satisfying in all the patients. Drainage volume averaged 80. 6 ml （50 to 150 ml）. The patients were followed up for 1 to 12 months after the operation, during which no complications occurred. Conclusions Endoscopic thyroidectomy via breast approach using gasless anterior neck skin lifting method is a safe and low-cost procedure. By using the method, CO2 insufflation-related complications can be avoided. Although the operational space established by this method is relatively small, the operation can be completed without much difficulies.
出处
《中国微创外科杂志》
CSCD
2008年第10期954-955,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
悬吊器
免充气
内镜
胸乳入路
甲状腺切除术
Abdomen suspending device
Gasless
Endoscopy
Breast approach
Thyroidectomy
