CAJ | 학술논문

目的探讨腔镜辅助甲状腺切除术(MIVAT)中喉返神经的解剖定位标志及避免神经损伤的操作技巧.方法 2008年8月至2010年8月开展MIVAT 106例,其中8例中转为开放手术.术中以"气管、颈动脉间隙"结合"气管外侧壁中、后份"作为解剖标志定位喉返神经.结果术中共需探测喉返神经98条,其中97条(98.98%)喉返神经通过上述解剖标志被顺利探查到,未探查到的1例为右侧非返性喉返神经;1例(1.02%)术后出现一过性喉返神经麻痹,无永久性喉返神经麻痹发生.结论在MIVAT术中,"气管、颈动脉间隙"结合"气管外侧壁中、后份"是安全有效的喉返神经解剖定位标志.
목적 탐토강경보조갑상선절제술(MIVAT)중후반신경적해부정위표지급피면신경손상적조작기교.방법 2008년8월지2010년8월개전MIVAT 106례,기중8례중전위개방수술.술중이"기관、경동맥간극"결합"기관외측벽중、후빈"작위해부표지정위후반신경.결과 술중공수탐측후반신경98조,기중97조(98.98%)후반신경통과상술해부표지피순리탐사도,미탐사도적1례위우측비반성후반신경;1례(1.02%)술후출현일과성후반신경마비,무영구성후반신경마비발생.결론 재MIVAT술중,"기관、경동맥간극"결합"기관외측벽중、후빈"시안전유효적후반신경해부정위표지.
Objective To study the anatomic landmarks of recurrent laryngeal nerve (RLN) in minimally invasive video-assisted thyroidectomy (MIVAT), and to evaluate the operative skills to avoid nerve injury. Methods 106 patients were enrolled in the study dated between August 2008 and August 2010, in which 8 patients were converted to the conventional thyroidectomy. Intraoperative anatomic landmarks for location of RLN were the gap between trachea and carotid artery (GTC), as well as the middle and posterior portion of tracheal wall. Results 98 RLN were at risk, and 97 (98.98 %) nerves were recognized by means of two landmarks. 1 nerve failed to locate which was non-recurrent laryngeal nerve. Temporary RLN paralysis happened to 1 nerve(1.02 %), and no permanent RLN paralysis appeared. Conclusion GTC combined with middle and posterior portion of tracheal wall are safe and effective anatomic landmarks to locate RLN in MIVAT.