CAJ | 학술논문

目的：探讨3D腔镜辅助甲状腺手术的可行性与安全性。方法2014年1～4月，选择甲状腺单双侧良性病变、甲状腺微小癌以及甲状旁腺病变10例，在3 D腔镜辅助下，经颈前胸骨凹上方约一横指处2～4 cm弧形切口行局部病灶或患侧腺叶切除，其中2例术中冰冻病理证实甲状腺微小乳头状癌，行患侧Ⅵ区淋巴结清扫。结果10例手术均在3 D腔镜辅助下顺利完成，术中无异常出血，无中转开放手术，手术时间30～90 min，（61．8±22．4） min；术中出血量1．3～93．0 g，中位数5．2 g。术后随访1～4个月，未出现喉返神经、喉上神经和甲状旁腺损伤等并发症。结论3D腔镜辅助行甲状腺手术安全、可行，相对于2D技术，空间立体感强，更有利于局部精细解剖，有利于功能保护。
목적：탐토3D강경보조갑상선수술적가행성여안전성。방법2014년1～4월，선택갑상선단쌍측량성병변、갑상선미소암이급갑상방선병변10례，재3 D강경보조하，경경전흉골요상방약일횡지처2～4 cm호형절구행국부병조혹환측선협절제，기중2례술중빙동병리증실갑상선미소유두상암，행환측Ⅵ구림파결청소。결과10례수술균재3 D강경보조하순리완성，술중무이상출혈，무중전개방수술，수술시간30～90 min，（61．8±22．4） min；술중출혈량1．3～93．0 g，중위수5．2 g。술후수방1～4개월，미출현후반신경、후상신경화갑상방선손상등병발증。결론3D강경보조행갑상선수술안전、가행，상대우2D기술，공간입체감강，경유리우국부정세해부，유리우공능보호。
Objective To investigate the feasibility and safety of three-dimensional video-assisted thyroidectomy (3D VAT). Methods During January to April of 2014, 10 cases with unilateral or bilateral thyroid benign diseases , thyroid cancer, or parathyroid lesions were enrolled .The 3D VAT was carried out by using a 10-mm 3D stereoscopic endoscope .Local excision or lobectomy was performed via a 2-4 cm curve skin incision one finger above the sternal notch .In two patients , lobotomy combined with systematic lymphadenectomy was performed when papillary thyroid microcarcinoma was identified during operation . Results All the procedures were accomplished successfully under 3D video-assisted system, without intra-operative abnormal blood loss or conversion to conventional thyroidectomy .The operative time was 30-90 min (61.8 ±22.4 min);the intra-operative blood loss was 1.3-93.0 g (median, 5.2 g).All the patients were followed up for 1-4 months.Neither intra-nor post-operative complications about recurrent laryngeal nerve , superior laryngeal nerve , or parathyroid were observed . Conclusions Preliminary impression emerging from this study seems to suggest that 3D VAT is safe and effective.Compared with 2D surgery, a good perception of depth and easy recognition of anatomic structures are noticeable .