目的 探讨达芬奇机器人在原发性甲状旁腺功能亢进外科治疗中的安全性及有效性。方法 回顾性分析2014年11月至2017年12月在我科行达芬奇机器人外科手术系统辅助外科治疗的12例原发性甲状旁腺功能亢进病人的临床资料。术前定性诊断、精确定位。检测手术前、后血清全段甲状旁腺素、血钙、血磷变化情况。术后观察有无出血、声音嘶哑及饮水呛咳等并发症,随访2~24个月病人临床症状变化情况。结果 12例手术均在达芬奇机器人外科手术系统辅助下顺利完成,无中转开放手术,无手术相关严重并发症发生。手术时间(58.00±17.37)(38~89) min,术中出血(25.00±4.75)(20~35) mL。7例病人出现一过性低钙血症,经过补钙和维生素D治疗后痊愈。所有病人对手术美容效果满意。1例甲状旁腺增生病人术后复发,其余病人随访期间无复发征象。结论 达芬奇机器人辅助下外科手术治疗有严格手术适应证的原发性甲状旁腺功能亢进病人安全、有效,美容效果更佳。
贺青卿, 周鹏, 庄大勇, 朱见, 范子义, 郑鲁明, 岳涛, 王猛, 王丹, 李小磊
. 达芬奇机器人辅助外科治疗原发性甲状旁腺功能亢进[J]. 外科理论与实践, 2018
, 23(02)
: 130
-134
.
DOI: 10.16139/j.1007-9610.2018.02.010
Objective To evaluate the safety and effectiveness of surgical treatment of the patients with primary hyperparathyroidism using da Vinci Si surgical system. Methods A retrospective analysis was performed on the clinical data of 12 patients with primary hyperparathyroidism in our department who received robotic-assisted parathyroidectomy using da Vinci Si surgical system from November 2014 to December 2017. Preoperative diagnosis with precise localization of parathyroid had been done. Blood parathyroid hormone, calcium and phosphate levels were detected before and after operation. Postoperative complications such as bleeding, hoarseness and cough of drinking water were analyzed and the patients were followed up from 2 to 24 months. Results All twelve cases had successful robotic parathyroidectomy assisted with the da Vinci Si surgical system. There were no severe operative complications and no conversions to open surgery. The operation time was(58± 17.37)(38~89) min and intraoperative blood loss was(25± 4.75)(20~35) mL. Transient hypocalcemia occurred in 7 cases postoperatively and cured with calcium and vitamin D. The postoperative cosmetic result was excellent. The patients had no postoperative recurrence during the period of follow-up except 1 patient with parathyroid hyperplasia. Conclusions It showed that the surgical treatment of primary hyperparathyroidism assisted with da Vinci Si surgical system was safe and effective when the surgical indication was fully established, especially suitable for the patients with cosmetic requirements.
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