腔镜下甲状腺切除术的临床应用

目的：探讨完全腔镜下甲状腺手术的可行性及术中避免神经损伤及甲状旁腺损伤的方法。方法采取完全乳晕入路及胸乳入路完成腔镜下甲状腺切除术手术296例。结果296例手术成功，无中转开放手术。术后有2例甲状旁腺损伤，出现麻木及抽搐，给予钙剂治疗，共有5例喉返神经麻痹，出现声音嘶哑，给予理疗好转，平均恢复时间1～4个月，1例术后出现分离间隙淤血，后经穿刺抽液三次后愈，胸前水肿一个月后消褪。术后患者均自述有术区麻木感，1～3个月后自行消除。全部患者对切口美容效果满意，术后随访1～30个月，无复发。结论完全腔镜下甲状腺手术是一个安全有效的手术方法，在心理微创与美容效果有明显的优势。

The experiences of cases complete endoscopic thyroidectomy

Discussing the possibilities of thyroid surgery under complete endoscope and the means of avoiding never injury and gley’s glands injury. Endoscopic thyroidectomy via the areola of the breast approach was performed in 296 cases. 296 cases surgeries succeed, without transferring and open surgery. 2 cases get gley’s glands injury with numbness and convulsion, and were cured by administration of calcium. 5 cases had transient recurrent laryngeal nerve paralysis, recovering after 1~4 months. One case get separating gap congestion after surgery, and was cured by given 3 times of paracentesis, chest edema disappeared a month later. AU patients claimed numbness in operation area, which discppeared with in 1 to 3 months. The patients were followed up for 1 to 30 months with satisfactory results. All patients were satisfied with the cosmetic effects of the operation. Endoscopic thyroidectomy is safe and feasible, with obvious advantages.