CAJ | 학술논문

目的探讨改良单悬吊无注气腔镜手术在双侧甲状腺手术中的应用价值.方法将42例行腔镜下双侧甲状腺手术的甲状腺良性病变患者按手术方法分为两组:无注气组15例行改良单悬吊无注气腔镜手术,注气组27例行传统注气腔镜手术.比较两组术中和术后情况.结果 42例手术均在腔镜下完成,无中转开放患者.无注气组中9例完成双侧腺叶次全切除术,5例完成一侧腺叶全切除及一侧腺叶次全切除术,1例完成双侧腺叶全切除术.注气组中17例完成双侧腺叶次全切除术,7例完成一侧腺叶全切除及一侧腺叶次全切除术,3例完成双侧腺叶全切除术.两组手术时间、术中出血量、术后住院时间比较差异无统计学意义(P＞0.05).无注气组术后并发症发生率明显低于注气组[2/15比51.85％(14/27)],差异有统计学意义(P＜0.05).结论改良单悬吊无注气腔镜手术可避免注气手术的相关并发症,手术暴露视野良好,操作简单安全,具有临床推广价值.
목적 탐토개량단현조무주기강경수술재쌍측갑상선수술중적응용개치.방법 장42례행강경하쌍측갑상선수술적갑상선량성병변환자안수술방법분위량조:무주기조15례행개량단현조무주기강경수술,주기조27례행전통주기강경수술.비교량조술중화술후정황.결과 42례수술균재강경하완성,무중전개방환자.무주기조중9례완성쌍측선협차전절제술,5례완성일측선협전절제급일측선협차전절제술,1례완성쌍측선협전절제술.주기조중17례완성쌍측선협차전절제술,7례완성일측선협전절제급일측선협차전절제술,3례완성쌍측선협전절제술.량조수술시간、술중출혈량、술후주원시간비교차이무통계학의의(P＞0.05).무주기조술후병발증발생솔명현저우주기조[2/15비51.85％(14/27)],차이유통계학의의(P＜0.05).결론 개량단현조무주기강경수술가피면주기수술적상관병발증,수술폭로시야량호,조작간단안전,구유림상추엄개치.
Objective To study the application value of modified single suspension and gasless endoscopy technology (MSSGET) in bilateral thyroid surgery.Methods Forty-two thyroid benign lesion patients who had bilateral thyroid surgery under endoscope were divided into 2 groups according to the surgery method:gasless group (15 cases) used MSSGET,gas injection group (27 cases) used traditional gas injection endoscopy surgery.The conditions during intraoperative and postoperative were compared.Results All the 42 patients were completed endoscopy surgery,the patients in the 2 groups did not turn into operation.In the gasless group,9 cases underwent subtotal resection of thyroid gland lobes on both sides,5 cases underwent total resection of thyroid gland lobe on one side and part resection of thyroid gland lobe on the other side,1 case underwent total resection of bilateral thyroid gland lobes.In the gas injection group,17 cases underwent subtotal resection of thyroid gland lobes on both sides,7 cases underwent total resection of thyroid gland lobe on one side and part resection of thyroid gland lobe on the other side,3 cases underwent total resection of bilateral thyroid gland lobes.There were no statistical differences in the time of operation,intraoperative bleeding,time of staying in hospital between the 2 groups (P ＞ 0.05).The incidence of postoperative complication in gasless group was significantly lower than that in gas injection group [2/15 vs.51.85％ (14/27)],there was statistical difference (P ＜ 0.05).Conclnsions MSSGET can avoid complication associated with gas injection surgery.In terms of the MSSGET,the surgical vision is good,the operation is simple and safe,so the method has clinical popularization value.