CAJ | 학술논문

目的总结胸骨后甲状腺肿外科手术治疗经验.方法胸骨后甲状腺肿102例均行手术切除,手术方式包括:(1)颈低领式切口手术切除74例;(2)较大、更低的低领式切口,肩部垫枕约高20度使颈部过伸,此法手术切除12例;(3)横断一侧或双侧舌骨下肌群手术切除8例;(4)颈部低领式切口加胸部正中纵切口,胸骨体在2、3肋间横向锯断,显露上纵隔血管及病变,直视下完整切除甲状腺癌或巨大甲状腺肿8例.结果所有患者手术均获成功.术后声嘶7例,4例1个月后发声恢复正常,3例因癌侵犯喉返神经,声嘶无改善.9例甲状旁腺损伤致低钙抽搐,2～3个月均恢复.本组102例均获随访1～3年均无复发. 结论经颈部切口或胸骨部分劈开手术适于胸骨后甲状腺肿手术.术前CT扫描、胸片对手术方式的选择具有指导意义.
목적 총결흉골후갑상선종외과수술치료경험.방법 흉골후갑상선종102례균행수술절제,수술방식포괄:(1)경저령식절구수술절제74례;(2)교대、경저적저령식절구,견부점침약고20도사경부과신,차법수술절제12례;(3)횡단일측혹쌍측설골하기군수술절제8례;(4)경부저령식절구가흉부정중종절구,흉골체재2、3륵간횡향거단,현로상종격혈관급병변,직시하완정절제갑상선암혹거대갑상선종8례.결과 소유환자수술균획성공.술후성시7례,4례1개월후발성회복정상,3례인암침범후반신경,성시무개선.9례갑상방선손상치저개추휵,2～3개월균회복.본조102례균획수방1～3년균무복발. 결론 경경부절구혹흉골부분벽개수술괄우흉골후갑상선종수술.술전CT소묘、흉편대수술방식적선택구유지도의의.
Objective To summarize surgical experience for the treatment of substernal goiter.Methods 102 cases of substernal goiter underwent surgical resection,in 74 by low collar incision,12 cases by larger low collar incision and pillowing the shoulder pad about 20 degrees for neck hyperextension,8 cases by unilateral or bilateral infrahyoid muscles transection,8 cases by low collar and up-mid-sternal incision plus horizontal sawing in 2 and 3 ribs.Results Resection was performed successfully in all cases.Hoarseness occurred in 7 cases,4 cases recovered after one month,3 cases did not improve because of tumor invasion of laryngeal recurrent nerve.Postoperative transient hypocalcemia in 9 cases recovered after 2 to 3 months.102 patients were followed up for 1 to 3 years without recurrence.Conclusions Substernal goiter can be resected successfully through a transcervical approach or mid-sternal incision.CT scanning and chest X radiograph are decisive for the surgical approach.