摘要
目的探讨经锁骨下斜切口侧入路行单侧甲状腺手术的可行性及效果。方法回顾性分析2006年1月～2011年12月我科施行的单侧甲状腺手术359例的临床资料。颈前低领弧形小切口(LI)110例,单侧锁骨上斜切口(Sup-I)159例,单侧锁骨下斜切口(Sub-I)90例,将三组术前、术中、术后资料进行对比分析。结果三组病人均顺利完成手术,伤口一期愈合出院,术后随访3～24个月,复查无肿瘤残留及复发。在切口平均长度、手术平均时间、平均失血量等指标上,3组间无明显差异;在并发症上,3组发生喉返神经损伤例数均为1例,无统计学意义;但3组中伤口瘢痕粘连分别为:10、1、0,LI切口明显高于另两组,有统计学差异(P=0.02),而美容满意度Sub-I组优于LI及Sup-I组(P<0.001)。结论对单侧甲状腺结节经由锁骨下斜切口侧入路手术安全、切口粘连的并发症少,且术后瘢痕隐蔽,颈部外形美观。
Objective To explore the feasibility and effect of unilateral thyroid operations by subclavicular oblique incision. Methods A total of 359 cases of unilateral thyroid operations performed between Jan 2006 and Dec 2011 were retrospectively analyzed. Pre-, intra-and post- operative information were compared. All patients were divided into three groups based on incision types for thyroidectomy, low-collar incision （LI group, n= 110）, supraclavicular oblique incision （Sup-I group, n=159） and subclavicular oblique incision （Sub-I group, n=90）. Results All of operations in three groups were accomplished successfully, and the patients healed by first intention. Among the 3-24 months of follow-up, no case of tumor residual and recurrence were found. There was no significant difference of mean incision length, operating time and blood loss. One case of recurrent laryngeal nerve injury occurred in each group, with insignificant difference in statistics analysis. Scar adhesion occurrences were 10, 1, 0 respectively in LI, sup-I and sub-I group respectively, with significant difference in three groups （P〈0.001）. The appearance was more satisfactory in the Sub-I group （P〈O.O01）. Conclusion The unilateral thyroid surgery by subclavicular oblique incision has the advantage of safety, lower complications, cosmetic result and is worth for clinical expansion.
出处
《岭南现代临床外科》
2013年第5期442-445,共4页
Lingnan Modern Clinics in Surgery
关键词
锁骨下斜切口
甲状腺
手术
颈部美学
Subclavicular oblique incision
Thyroid
Operate
Neck aesthetics
