Baca I, Jacek G, Grzybowski L
Klinik für Allgemein- und Unfallchirurgie, Zentralkrankenhaus Bremen-Ost, Bremen.
Zentralbl Chir. 2000;125(11):916-9. doi: 10.1055/s-2000-10064.
We report our experience and technique of endoscopic removal of parathyroid adenomas in case of primary hyperparathyroidism. Scintigraphy, MRI scan and cervical ultrasound enable exact diagnosis and therefore exact localisation and placement of the three 5 mm trocars for endoscopic operation. The placement of the optic and the function trocars depends on the localisation of the adenoma. The free room to work in is created between thyroid and neck muscles and supported by insufflated CO2 with a pressure of 12 mm Hg. After the adenoma is taken out through an incision above the jugulum. With this technique we operated upon 3 patients successfully. Benefits for the patients seem to be a less painful postoperative course with minimal blood loss because of the exact exploration of the adenoma with minimal invasion of the surrounding tissue.
我们报告了在原发性甲状旁腺功能亢进症病例中,采用内镜切除甲状旁腺腺瘤的经验和技术。闪烁扫描、磁共振成像扫描和颈部超声检查可实现准确诊断,从而精确确定用于内镜手术的三个5毫米套管针的定位和放置位置。观察镜套管针和操作套管针的放置取决于腺瘤的位置。在甲状腺和颈部肌肉之间创造出操作空间,并通过注入压力为12毫米汞柱的二氧化碳来维持。腺瘤通过颈静脉上方的切口取出。通过该技术,我们成功为3例患者进行了手术。对患者而言,由于对腺瘤进行了精确探查,对周围组织的侵入最小,术后疼痛较轻且失血极少,似乎是其优点。