中国临床解剖学杂志 ›› 2024, Vol. 42 ›› Issue (3): 322-325.doi: 10.13418/j.issn.1001-165x.2024.3.13

• 临床研究 • 上一篇    下一篇

喉返神经全程显露三步法于经胸前入路腔镜甲状腺手术的应用

邹洋,    刘佳龙,    金一怡,    李宁磊,    孙景波,    刘晓珑*   

  1. 南方医科大学第三附属医院普通外科,  广州   510630
  • 收稿日期:2023-10-20 出版日期:2024-05-25 发布日期:2024-06-28
  • 作者简介:邹洋(1998-),男,重庆人,硕士在读,研究方向:甲状腺、乳腺外科治疗及相关临床研究,E-mail:surgeon_zy@qq.com
  • 基金资助:
     广东省科学技术厅“海外名师”项目;南方医科大学第三附属医院院长基金面上项目(YM202208)

Application of the three-step method of full laryngeal recurrent nerve visualization in laparoscopic thyroidectomy via anterior chest approach

Zou Yang, Liu Jialong, Jin Yiyi, Li Ninglei, Sun Jingbo, Liu Xiaolong*   

  1. Department of General Surgery, the Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, China
  • Received:2023-10-20 Online:2024-05-25 Published:2024-06-28

摘要:  目的    探究喉返神经全程显露三步法应用于经胸前入路腔镜甲状腺切除术预防喉返神经暂时性损伤的效果。  方法    回顾性分析2021年7月至2023年7月作者团队运用喉返神经全程显露三步法进行的78例经胸前入路腔镜甲状腺切除术的手术录像以及患者临床资料,观察术中喉返神经全程显露情况,以及术后出现喉返神经损伤症状或其他不良反应。  结果    78例手术均成功完成,无中转开放手术,共全程显露喉返神经117条,术中出血量20~100 mL(平均37.8 mL),术后均未发现声音嘶哑、发声无力或呼吸困难等喉返神经受损表现。  结论    经胸前入路腔镜甲状腺手术中运用喉返神经全程显露三步法有助于保护喉返神经,减少喉返神经热损伤,此方法操作简单,易于掌握,值得临床推广。

关键词: 腔镜; ,  , 甲状腺; ,  , 喉返神经保护; ,  , 甲状腺切除术

Abstract: Objective    To investigate the efficacy of applying the three-step method of full laryngeal recurrent nerve visualization to prevent laryngeal recurrent nerve injury during laparoscopic thyroidectomy via anterior chest approach.   Methods  The 78 surgical videos performed by the author's surgical team, from July 2021 to July 2023, as well as clinical data of the patients were retrospectively analyzed to observe intraoperative full laryngeal recurrent nerve visualization and postoperative occurrence of nerve injury symptoms or other adverse reactions.  Results   All the 78 surgical operations were successfully completed without intermediate open surgery, and altogether 117 recurrent laryngeal nerves were exposed throughout the operation, with intraoperative bleeding of 20-100 mL (average 37.8 mL). No symptoms of recurrent laryngeal nerve damage, such as hoarseness of voice or dysphagia, were observed in all 78 patients after the operation.  Conclusions   The three-step method of full laryngeal recurrent nerve visualization in laparoscopic thyroidectomy via anterior chest approach  contributes to the protection of the functional integrity of the recurrent laryngeal nerve and reduces the recurrent laryngeal nerve injury by latent heat, and this method can be operated conveniently with easy learning, which is worth to be popularized in the clinic.

Key words: Laparoscope; ,  , Thyroid; ,  , Recurrent laryngeal nerve; ,  , Endoscopic thyroidectomy

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