Clinical application of retrograde thyroidectomy from top to bottom in retrosternal thyroid surgery
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摘要: 目的 探讨自上而下逆行切除甲状腺的手术操作方法在胸骨后甲状腺肿手术中的应用价值。方法 回顾性分析2017年1月—2022年6月本组手术医生用自上而下逆行切除胸骨后甲状腺肿的病例，总结手术操作的技术要点、可行性及优点。结果 共收集使用该操作方法切除胸骨后甲状腺肿15例，其中Ⅰ型胸骨后甲状腺肿5例，Ⅱ型胸骨后甲状腺肿10例，术后病理均为良性。单侧胸骨后甲状腺肿手术时间为40~60 min，双侧70~90 min。所有患者术后均无出血、声嘶、甲状旁腺功能低下表现。术后7 d内均正常出院，无手术相关并发症表现。结论 自上而下切除甲状腺的方法适用于Ⅰ、Ⅱ型胸骨后甲状腺肿手术，可以避免常规手术方法因胸骨后的甲状腺下极难以暴露分离导致手术时间延长的弊端，加快了手术速度降低了操作难度，在临床上有一定的推广价值。Abstract: Objective To investigate the value of retrograde thyroidectomy from top to bottom in the operation of retrosternal thyroid surgery.Methods Retrospective analysis was performed on the cases of retrosternal goiter excised by our surgeons from January 2017 to June 2022, the technical points, feasibility and advantages of the operation were summarized.Results A total of 15 cases of retrosternal goiter treated by retrograde thyroidectomy were collected, including 5 cases of type Ⅰ retrosternal goiter and 10 cases of type Ⅱ retrosternal goiter.The postoperative pathology was benign. The surgical time is 40-60 minutes for unilateral retrosternal goiter and 70-90 minutes for bilateral goiter. All patients were discharged normally within 7 days after operation, and no operative complications were observed such as bleeding, hoarseness or hypoparathyroidism.Conclusion This surgical excision method of thyroid is suitable for the type Ⅰ and type Ⅱ retrosternal goiter surgery, which can avoid the difficulties in exposing and separating the the inferior thyroid behind the sternum in conventional surgical method, speed up the operation and reduced the difficulty of operation, and has certain promotion value in clinic.
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Key words:
- goiter /
- posterior sternum /
- surgical operation
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