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目的 探讨胸骨后甲状腺肿物切除手术入路及方法。方法 回顾分析 2 7例胸骨后甲状腺肿物临床资料。结果 2 7例胸骨后甲状腺肿物患者接受外科治疗 ,均获成功。其中结节性甲状腺肿 10例 ,甲状腺腺瘤 9例 ,结节性甲状腺肿癌变 4例 ,甲状腺乳头状癌伴气管旁淋巴结转移 3例 ,甲状腺滤泡状癌伴气管旁和纵隔淋巴结转移 1例。 2 3例 (良性病变 19例 ,恶性肿瘤 4例 )颈部低位领式切口入路切除 (占 85 2 %) ,3例颈部低位领式切口并胸骨正中劈开入路的占 11 1%,1例开胸入路并颈部低位领式切口入路切除 (占 3 7%)。术后并发症发生率为 2 5 9%,其中术后伤口出血较为常见 ,占 42 9%。结论 颈部低位领式切口入路切除胸骨后甲状腺肿物是可行的 ,它容易操作 ,安全可靠 ,又具有损伤小、并发症少等优点。
Objective To explore the surgical approach and methods of sternal back thyroidectomy. Methods The clinical data of 27 cases of retrosternal thyroid tumors were analyzed retrospectively. Results Twenty-seven patients with poststernal thyroid tumors received surgical treatment and all were successful. There were 10 cases of nodular goiter, 9 cases of thyroid adenoma, 4 cases of nodular goiter cancer, 3 cases of thyroid papillary carcinoma with paratracheal lymph node metastasis, and 1 case of thyroid follicular carcinoma with paratracheal and mediastinal lymph node metastases. . Twenty-three cases (19 cases with benign lesions and 4 cases with malignant tumors) were treated with low-cut neck incision (85.2%), and 11 cases with 3 cases with low neck collar incision and median sternotomy approach. One patient received a thoracotomy approach and a low neck collar incision (37%). The incidence of postoperative complications was 25.9%, of which postoperative wound bleeding was more common, accounting for 42.9%. Conclusion It is feasible to remove the retrosternal thyroid mass with a low neck collar incision. It is easy to operate, safe and reliable, and has the advantages of less injury and fewer complications.