经乳晕入路腔镜甲状腺切除术并发症的预防及处理

摘要

目的：探讨经乳晕入路腔镜甲状腺切除术常见并发症的原因及处理方法，总结防治经验，使该手术方式更加安全。方法回顾性分析自2012年5月1日至2013年4月30日对416例需行甲状腺切除术患者行经乳晕入路腔镜甲状腺切除术的术中及术后并发症。结果416例患者中，415例成功在腔镜下完成手术。术中除3例出血（1例转为开放）外，无严重并发症；术后主要并发症为暂时性甲状旁腺功能低下、一过性声音嘶哑、颈胸部皮肤发紧、脑循环紊乱综合征等，无永久性甲状旁腺功能低下、喉返神经损伤。结论经乳晕入路腔镜甲状腺切除术是一种安全而可行的手术方法，熟悉甲状腺的解剖结构，熟练的腔镜操作技术，认真仔细的手术操作可以降低并发症发生率。%Objective To investigate the prevention and treatment of complications during or after endoscopic thyroidectomy via breast approach,make the operation more safer. Methods 416 patients who  were needed thyroidectomy underwent endoscopic thyroidectomy via breast approach between May 1st, 2012 and April 30th, 2013. The complications of those cases were retrospectively analyzed. Results The 416 patients, 415 cases of successful underwent the endoscopic to complete the operations. There was no serious complications occurred during the procedures except 3 cases bleeding seriously(1 case was converted to open surgery). The main postoperative complications included temporary low parathyroid function, transient hoarseness, neck and chest skin tightening feeling, cerebral circulation disorder syndrome. There are no perpetual low parathyroid function and laryngeal nerve injury. Conclusions Endoscopic thyroidectomy via breast approach is a safe and feasible operation. It is important for surgeon to have detailed acknowledgement in the anatomy of thyroid gland, skillful manipulation of procedure in preventing and decreasing the complications of endoscopic thyroidectomy via breast approach.