Banasiewicz Tomasz, Meissner Wiktor, Pyda Przemysław, Wierzbicki Tomasz, Głyda Michał, Musiał Mikołaj, Smoliński Szymon, Iwanik Katarzyna, Drews Michał
Department of General, Gastroenterological and Endocrine Surgery, K. Marcinkowski Medical University, Ul. Przybyszewskiego 49, 60-355, Poznań, Poland.
Langenbecks Arch Surg. 2008 Sep;393(5):715-9. doi: 10.1007/s00423-008-0345-z. Epub 2008 May 28.
Partial thyroidectomy under local anaesthesia was performed in 49 subsequent individuals in the Central African Republic. Because of the shortage of medical resources, all patients with goitre were scheduled for an operation under local anaesthesia.
There were no inclusion or exclusion criteria applied for patient selection for the procedure. Before the operation, patients had received an oral sedation and antibiotic. For infiltration anaesthesia, 1% lignocaine was used.
Subtotal bilateral thyroidectomy was performed in 37 patients; 12 patients underwent lobectomy or partial lobectomy of the affected portion of the gland. There were no intraoperative complications in any of the patients. The mean time of the procedure averaged 127 min. There were no postoperative complications noticed in the reported group, and this includes also complications related to laryngeal nerve injury. General condition of the operated on patients allowed for full self-dependency within 4 to 6 h postoperatively. Patients remained under medical surveillance for mean 3 days, and cutaneous stitches were removed on the first postoperative day. General condition of all patients on the day of discharge from hospital was good.
Surgery for goitre under local anaesthesia may be a safe alternative where general anaesthesia is not available or contraindicated for medical reasons.
在中非共和国，后续有49名患者接受了局部麻醉下的甲状腺部分切除术。由于医疗资源短缺，所有甲状腺肿患者都被安排接受局部麻醉下的手术。
该手术的患者选择没有应用纳入或排除标准。手术前，患者接受了口服镇静剂和抗生素治疗。浸润麻醉使用的是1%利多卡因。
37例患者接受了双侧甲状腺次全切除术；12例患者接受了腺叶切除术或病变部分的部分腺叶切除术。所有患者均未出现术中并发症。手术平均时间为127分钟。报告组未发现术后并发症，这也包括与喉返神经损伤相关的并发症。接受手术患者的一般状况在术后4至6小时内即可完全自理。患者平均接受医学监测3天，术后第一天拆除皮肤缝线。所有患者出院当天的一般状况良好。
在无法获得全身麻醉或因医学原因禁忌全身麻醉的情况下，局部麻醉下的甲状腺肿手术可能是一种安全的选择。
