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时间:2020-05-15
《腔镜辅助微创甲状旁腺腺瘤切除术14例诊治报告.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、·238·史国磋螳lJ夕科杂志2015年3月第15卷第3期ChinJMinInvSurg。March2015.V01.15.N0.3临床研究·腔镜辅助微创甲状旁腺腺瘤切除术14例诊治报告周京安贺建业李洋(首都医科大学附属北京安贞医院普外科,北京100029)【摘要】目的探讨腔镜辅助微创甲状旁腺腺瘤切除术(minimally—invasivevideo_assistedparathyroidectomy,MIVAP)的安全性与可行性。方法回顾性分析2011年4月~2014年9月我科引起原发性甲状旁腺功能亢进的甲状旁腺腺瘤14例资料
2、,其中6例同时合并甲状腺病变。术前明确定性及定位诊断,行腔镜辅助小切口甲状旁腺腺瘤切除及甲状腺病灶切除,术中冰冻、术后免疫组化病理检查,术中、术后监测甲状旁腺激素水平变化,术后观察有无声音嘶哑、饮水呛咳、活动性出血发生。结果14例手术均在腔镜辅助下顺利完成,术中无异常出血,无中转开放手术,手术时间35~60min,平均50min。术中出血量1.7—32.0g,平均9.75g。术后无暂时性或永久性喉返神经、喉上神经损伤和出血等并发症发生。14例术后随访243个月,平均16个月,均无复发。结论术前充分定性、定位,辅以术中甲状旁腺激素
3、水平监测,腔镜辅助微创甲状旁腺腺瘤切除及甲状腺病灶切除是安全、可行的。【关键词】腔镜辅助微创甲状旁腺手术;甲状旁腺腺瘤;原发性甲状旁腺功能亢进中圄分类号:R653文献标识:A文章编号:1009—6604(2015)03—0238—04doi:10.3969/i.issn.1009—6604.2015.03.012Minimally-invasiveVideo·assistedParathyroidectomyforParathyroidAdenoma:aReportof14CasesZhouJing’an,HeJianye,Li
4、Yang.DepartmentofGeneralSurgery,BeringAnzhenHospitalofCapitalMedicalUniversity,Beijing100029,ChinaCorrespondingauthor:HeJianye,E—maiZ:anzhenhjy@163.con【Abstract】0bjectiveToinvestigatethefeasibilityandsafetyofminimally—invasivevideo·assistedparathyr0idect0my(MIVAP)for
5、parathyroidadenoma(PA).MethodsClinicaldataof14patientswithprimaryhyperparathyroidism(PHPT)causedbyPAbetweenApril2011andSeptember2014inourhospitalwereanalyzedretrospectively.Coexistentthyroidlesionswerefoundin6patients.Withpreoperativedefinitediagnosisandlocalization,
6、weperformedparathyroideetomyandlocalexcisionorlobectomyofthethyroidgland.Allthepatientswereconfirmedbyintra-operativefastfrozensectionpathologicalexaminationandpostoperativepathologicalimmunohistochemistry.Intra-andpost-operativeparathyroidhormonemonitoringwasconduct
7、ed.Hoarseness,chokingcough,andactivebleedingwereobserved.ResultsAlltheprocedureswereaccomplishedsuccessfully,withoutintra—operativeabnormalbloodlossorconversiontoconventionaloperation.Theoperativetimewas35—60min(mean,50min);theintra—operativebloodlosswas1.7—32.0g(mea
8、n,9.75g).Neithertransientnoreverlastinginjurytorecurrentlaryngealnerveorsuperiorlaryngealnervehappened.Nohemorrhagewasobserved.Allt
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