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颈部入路切除胸骨后甲状腺肿57例临床分析

蒋波 彭瑶 王浩 张哲嘉 冯铁诚 李劲东 谭辉 王志明 李新营

中国普通外科杂志2017,Vol.26Issue(3):347-351,5.
中国普通外科杂志2017,Vol.26Issue(3):347-351,5.DOI:10.3978/j.issn.1005-6947.2017.03.012

颈部入路切除胸骨后甲状腺肿57例临床分析

Excision of substernal goiter via cervical approach:a clinical analysis of 57 cases

蒋波 1彭瑶 1王浩 1张哲嘉 1冯铁诚 1李劲东 1谭辉 1王志明 1李新营1

作者信息

  • 1. 中南大学湘雅医院 普通外科甲状腺专科,湖南 长沙 410008
  • 折叠

摘要

Abstract

Objective: To investigate the indications and the surgical techniques for excision of substernal goiter via cervical approach. Methods: The clinical data and surgical results of 57 patients with substernal goiters undergoing surgical excision through cervical approach from January 2013 to September 2016 were retrospectively analyzed. Results: Of the 57 patients (including 2 cases of ectopic goiters), 22 cases had no obvious clinical symptoms and the other 35 cases presented with compression symptoms such as dyspnea, dysphagia and hoarseness; the lesions were classified according to Randolph's criteria as type I in 34 cases, type IIA in 16 cases, type IIB in 5 cases and type III in 2 cases, and based on CT classification as grade 1 in 30 cases, grade 2 in 18 cases and grade 3 in 9 cases, respectively. Cervical approach thyroidectomy was performed in all these patients, including repeat thyroid surgery in 6 cases (10.5%). There were benign diseases in 49 patients and differentiated thyroid cancers in 8 patients as evidenced by pathological findings. Postoperative complications included temporary vocal cord paralysis in one case (1.8%) and temporary hypocalcemia in 5 cases (8.8%). Conclusion: The majority of substernal goiters can be safely excised through cervical approach after thorough preoperative assessment. Excellent surgical skills, operation by experienced surgeons and readily accessible thoracotomy set are the premises and critical to surgical success.

关键词

甲状腺肿,胸骨后/外科学/甲状腺切除术/方法

Key words

Goiter/Substernal/surg/Thyroidectomy/method

分类

医药卫生

引用本文复制引用

蒋波,彭瑶,王浩,张哲嘉,冯铁诚,李劲东,谭辉,王志明,李新营..颈部入路切除胸骨后甲状腺肿57例临床分析[J].中国普通外科杂志,2017,26(3):347-351,5.

基金项目

国家自然科学基金资助项目(81672885). (81672885)

中国普通外科杂志

OA北大核心CSCDCSTPCD

1005-6947

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