CAJ | 학술논문

目的探讨采用低领小弧形切口对双侧甲状腺肿物行甲状腺近全切除术的可行性和特点.方法 1998年12月至2007年3月采用2～4 cm低领小弧形切口对53例甲状腺双侧肿物采用双侧腺叶近全切除术,其中结节性甲状腺肿34例,甲状腺瘤12例,甲状腺乳头状腺癌5例,桥本氏病并甲状腺乳头状腺癌1例,甲状腺髓样癌1例.肿物平均直径2.0 cm(0.8～3.5 cm).其中32例行一侧腺叶+峡部切除+对侧腺叶次全切除术,16例行双侧腺叶次全切除术即仅保留双侧腺上极小指肚大小腺体,5例行双侧腺全切除术仅保留峡部小指肚大小腺体.所有手术均充分显露甲状旁腺及喉返神经.结果对53例双侧甲状腺肿物行腺叶切除术采用低领小弧形切口,术野喉返神经及甲状旁腺显露充分,手术过程顺利,手术时间平均62.2 min(最短58～112 min),术中出血平均25 ml(10～100 ml).术后2～3 d拔除引流管.术后2～3 d术后切口均一期愈合,7～12 d出院,切口低小且易被衣领遮盖,美学效果较好.所有患者被随访12个月至9年,均未见肿瘤复发及甲状旁腺功能低下.所有手术患者均对手术切口美学效果满意.结论对甲状腺双侧肿物采用低领小弧形切口施行双侧甲状腺近全切除术具有术野显露充分,手术时间较短,手术安全,术后切口低小易被衣领遮盖,美学效果好的优点,较适用于中青年女性.
목적 탐토채용저령소호형절구대쌍측갑상선종물행갑상선근전절제술적가행성화특점.방법 1998년12월지2007년3월채용2～4 cm저령소호형절구대53례갑상선쌍측종물채용쌍측선협근전절제술,기중결절성갑상선종34례,갑상선류12례,갑상선유두상선암5례,교본씨병병갑상선유두상선암1례,갑상선수양암1례.종물평균직경2.0 cm(0.8～3.5 cm).기중32례행일측선협+협부절제+대측선협차전절제술,16례행쌍측선협차전절제술즉부보류쌍측선상겁소지두대소선체,5례행쌍측선전절제술부보류협부소지두대소선체.소유수술균충분현로갑상방선급후반신경.결과 대53례쌍측갑상선종물행선협절제술채용저령소호형절구,술야후반신경급갑상방선현로충분,수술과정순리,수술시간평균62.2 min(최단58～112 min),술중출혈평균25 ml(10～100 ml).술후2～3 d발제인류관.술후2～3 d술후절구균일기유합,7～12 d출원,절구저소차역피의령차개,미학효과교호.소유환자피수방12개월지9년,균미견종류복발급갑상방선공능저하.소유수술환자균대수술절구미학효과만의.결론 대갑상선쌍측종물채용저령소호형절구시행쌍측갑상선근전절제술구유술야현로충분,수술시간교단,수술안전,술후절구저소역피의령차개,미학효과호적우점,교괄용우중청년녀성.
Objective To explore the clinical feasibility and features of adopting a low-collar arcshaped incision for minimally invasive near total thyroidectomy. Methods From April 1998 to March 2007, the procedure was accepted by 53 patients with thyroidal nodules, including nodular goiter (n=34 ) , thyroid adenoma ( n = 12 ) and thyroid carcinoma ( n=7). Near total thyroidectomy was performed through a 2-4 cm low-collar horizontal skin incision by conventional instrumentation. Results The incision yielded excellent cosmetic results because the small and lower incisions were completely hidden by clothing collar. The recurrent laryngeal nerve and parathyroid glands were easily identified and preserved. The mean operation time was 62. 2 minutes (range: 58-112). No complication occurred. The mean bleeding amount was 25 ml ( min: 10, max:100). The drainage was extracted at Day 2 or 3 postoperatively. The mean postoperative stay was 7.6 days (range: 7-12) while the post-operative follow-up 2 months to 9 years. Conclusion Such technique is feasible, safe, minimally invasive, less time-consuming and cosmetically ideal. It is suitable for young and middle-aged women.