Ohshima Akira, Simizu Shuji, Okido Masayuki, Shimada Kazuo, Kuroki Syoji, Tanaka Masao
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Biomed Pharmacother. 2002;56 Suppl 1:48s-52s. doi: 10.1016/s0753-3322(02)00229-9.
During the last 3 years, 59 patients underwent endoscopic neck surgery. We started the video-assisted neck surgery with the gasless skin-lifting method for benign thyroid and parathyroid diseases to avoid complications of carbon dioxide (CO2) insufflation. Hemithyroidectomy was performed for benign thyroid tumors and subtotal thyroidectomy was selected for Graves' disease. Parathyroid adenomas were extirpated for primary hyperparathyroidism with precise preoperative localization by imaging modalities. In order to obtain a better visual field and to improve the cosmetic results, we have adopted the complete endoscopic method via breast approach with low CO2 insufflation pressure since August 2001. An intraoperative parathormone assay was introduced recently to confirm the complete removal of parathyroid adenomas. Both gasless and insufflation methods are feasible for endoscopic neck surgery with excellent cosmetic results.
在过去3年中，59例患者接受了内镜下颈部手术。我们采用无气皮肤提拉法开展视频辅助颈部手术，用于治疗良性甲状腺和甲状旁腺疾病，以避免二氧化碳（CO2）气腹的并发症。对良性甲状腺肿瘤行甲状腺次全切除术，对格雷夫斯病选择甲状腺次全切除术。通过影像学手段对原发性甲状旁腺功能亢进症进行精确的术前定位后，切除甲状旁腺腺瘤。为了获得更好的视野并改善美容效果，自2001年8月以来，我们采用了经乳房入路、低CO2气腹压力的完全内镜手术方法。最近引入了术中甲状旁腺激素检测，以确认甲状旁腺腺瘤已被完全切除。无气法和充气法在内镜下颈部手术中都是可行的，美容效果极佳。
