摘要
近年来,甲状腺乳头状癌的发病率增长迅速,并有年轻化的趋势,患者对美容的要求越来越高.全腔镜甲状腺癌功能性颈淋巴结清扫有较好的美容效果,对患者心理的创伤小;结合针式辅助技术可降低操作难度.针式辅助技术主要包括缝线悬吊、V型针式拉钩、MiniLap、3 mm腔镜器械的应用.在应用针式辅助技术行全腔镜甲状腺癌功能性颈淋巴结清扫时应谨慎掌握适应证.在手术操作中,需充分运用“关键点”“标志线”和“筋膜层面”进行定位,在腔镜视角下进行精准操作.另外,需根据分化型甲状腺癌颈淋巴结转移规律确定清扫的范围,以保证手术的安全性.
The incidence of papillary thyroid carcinoma is growing rapidly.Especially in young patients,the patients have high demand for better cosmetic effect and less psychological trauma.The application of laparoscope technique in papillary thyroid carcinoma surgery should meet the needs of patients.The development of needle assisted technique make it easy to access the neck potential fascial spaces,and provide the basic instrument for laparoscope modified neck dissection.The application of needle assisted techniques mainly include suture suspension and V type needle retractor,MiniLap,3 mm laparoscopic apparatus.Indications of this procedure is very important,and it is necessary to make full use of the ＂critical points＂,＂mark lines＂ and ＂fascia layers＂ to precise positioning in the operation.Furthermore,the levels of dissection must be determined based on the pattern of cervical lymph node metastasis in differentiated thyroid carcinoma,that will make the surgical procedures more safety.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2016年第11期823-827,共5页
Chinese Journal of Surgery
