CAJ | 학술논문

目的探讨术中超声在Miccoli微创甲状腺切除术中的临床意义.方法总结48例甲状腺多发肿瘤配合术中超声行Miccoli微创手术的资料.结果 48例平均切口长度2.5cm.1例术中冰冻切片病理为乳头状癌,中转行改良甲状腺癌手术.3例因术中冰冻切片无法确认良恶性行单侧甲状腺叶切除.44例均采用剜出或连带少量组织的肿瘤切除术或腺叶部分切除.结节和腺瘤的最大直径为0.4cm～5.0cm,平均约1.6cm.1例出现低血钙症状.随访6～18个月,1例甲状腺癌需服150μg优甲乐行抑制治疗.术后2例桥本甲状腺炎需服小剂量甲状腺素;其余术后的甲状腺激素水平均正常,无需用药.结论术中超声在Miccoli微创甲状腺切除术中的应用使手术更准确,避免了术中损伤,防止了肿瘤漏切.
목적 탐토술중초성재Miccoli미창갑상선절제술중적림상의의.방법 총결48례갑상선다발종류배합술중초성행Miccoli미창수술적자료.결과 48례평균절구장도2.5cm.1례술중빙동절편병리위유두상암,중전행개량갑상선암수술.3례인술중빙동절편무법학인량악성행단측갑상선협절제.44례균채용완출혹련대소량조직적종류절제술혹선협부분절제.결절화선류적최대직경위0.4cm～5.0cm,평균약1.6cm.1례출현저혈개증상.수방6～18개월,1례갑상선암수복150μg우갑악행억제치료.술후2례교본갑상선염수복소제량갑상선소;기여술후적갑상선격소수평균정상,무수용약.결론 술중초성재Miccoli미창갑상선절제술중적응용사수술경준학,피면료술중손상,방지료종류루절.
Objective To evaluate the significance of intaoperative ultrasound examination for minimal invasive video-assisted thyroidectomy.Methods The clinical data of 48 cases with multiple thyroid tumors in our hospital from Jun 2007 to Jan 2009 were studied.The intraoperative ultrasound examination was performed during minimal invasive video-assisted thyroidectomy.Results The average incision length of 48 patients were 2.0 cm.Only one case was converted due to thyroid papillary carcinoma diagnosed by intraoperative ultrasonography.3 patients underwent unilateral thyroid lobectomy due to intraoperative frozen-section examination unable to confirm benign or malignant.Others thyroid lesions were only resected or associated with a small amount of lobe tissues.The maximum diameter of thyroid lesions was 0.4 cm to 5.0 cm,an average of 1.6 cm.One case hypocalcemia was found after operation.During a follow-up time of 6 months to 18 months,one case of thyroid cancer needed to take 150 μg euthyrox.Two cases of Hashimoto's thyroiditis needed to take a small dose of thyroxine replacement therapy.The rest patients'thyroid hormones were normal.Conclusions Intraoperative ultrasonic examination in minimal invasive video-assisted thyroidectomy for multiple thyroid tumor makes the surgery more accurate,avoids intraoperative injury and prevents omission of thyroid nodes.