改良单悬吊无注气腔镜手术在双侧甲状腺手术中的应用研究

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.

Applied research on the modified single suspension and gasless endoscopy technology in bilateral thyroid surgery

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.