摘要
目的总结扶镜手在腔镜甲状腺手术中配合的体会。方法回顾性分析我科2012年10月~2016年3月经胸乳入路腔镜甲状腺手术118例的临床资料。行一侧腺叶部分切除22例,一侧腺叶全切除78例,双侧腺叶部分切除10例,双侧腺叶全切除8例。结果 118例均在腔镜下完成手术,无中转开放手术。术中出血量15~80 ml,(25±8)ml;手术时间75~190 min,(110±12)min。术中无喉返神经、喉上神经、气管等损伤,术中血管损伤8例,甲状旁腺损伤2例,均在腔镜下处理成功。结论在建立手术腔隙时必须显露"Y"形或"鱼叉形"的穿刺隧道、"上黄下红中间白"的胸前间隙和倒等腰三角形的颈前间隙;在切除腺体时,充分发挥主观能动性,注意解剖平面及标志,协助术者顺利完成手术。
Objective To summarize clinical experience of laparoscopic assistant in thyroid surgery. Methods A retrospective analysis was made on clinical treatment of 118 cases of endoscopic thyroidectomy by trans-thoracoareolar approach in our department from October 2012 to March 2016. There were 22 cases of unilateral lobe partial resection,78 cases of unilateral lobe total resection,10 cases of bilateral partial lobectomy,and 8 cases of bilateral total thyroidectomy. Results The operations were completed under endoscope in all the 118 cases,without conversions to open surgery. The intraoperative blood loss was 15-80 ml（ average,25 ± 8 ml） and the operation time was 75-190 min（ average,110 ± 12 min）. No recurrent laryngeal nerve,superior laryngeal nerve or trachea was injured in the operation. Intraoperative vascular injury happened in 8 cases and parathyroid injury happened in 2 cases,which were successfully cured with endoscopic treatment. Conclusions In the establishment of operation,the lacuna with the shape of＂Y＂or＂spear shaped＂must be revealed,as long as the＂upper yellow middle white lower red＂chest gap and inverted isosceles triangle neck gap. In the resection of the thyroid gland,correct understanding and making full use of local characteristics of thyroid anatomy,giving full play to the initiative,and paying attention to the dissection plane mark help complete surgery successfully.
出处
《中国微创外科杂志》
CSCD
北大核心
2017年第8期757-760,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
扶镜手
腔镜
甲状腺
Laparoscopic assistant
Endoscopy
Thyroid
