总结腔镜甲状腺切除手术后并发症的特点、原因和防治经验。

回顾性分析2009年6月至2012年6月经胸骨前入路行腔镜甲状腺切除手术226例患者的临床资料。

217例顺利完成手术,9例中转开放手术。腔镜手术时间90 ~ 200 min,平均(110 ± 15) min;术后并发喉返神经损伤3例,暂时性声音嘶哑8例,颈前皮下积液13例,颈前皮肤淤斑、红肿4例,颈前皮肤粘连3例,皮下气肿2例,颈胸皮肤紧张不适感5例。

腔镜甲状腺手术后最常见的并发症见于颈胸前皮瓣上,主要由于皮瓣的游离和超声刀的使用造成,此类并发症大多不需特殊处理。选择合适的病例,术后仔细观察病情,正确使用器械,可以减少和预防此类并发症的发生。

To summarize the incidence rate, reasons and precautions of postoperative complications in patients undergoing endoscopic thyroidectomy via anterior chest.

A retrospective analysis was carried out of clinical data for two hundred and twenty-six cases with laparoscopic thyroidectomy via anterior chest from June 2009 to June 2012.

The laparoscopic thyroidectomy was successfully carried out in 217 cases. The other 9 cases were converted to open surgery. The operation time ranged from 90 to 200 minutes, a mean of (110 ± 15) minutes. Recurrent laryngeal nerve injury occurred in 3 cases and temporary hoarse voice in 8 patients. Subcutaneous hydrops was found in 13 cases, skin ecchymosis and swelling in 4 cases, and skin adhesion at anterior chest in 3 cases. Two cases had postoperative subcutaneous pneumoderma, and five had intensity and discomfort of neck and thoracic skin.

The most common complication after endoscopic thyroidectomy is the subcutaneous hydrops mainly due to freeing the skin and use of ultrasound scalpel, most of which needs no special treatment and can be reduced or prevented by appropriate selection of the cases, careful observation, and proper use of equipment.