[甲状腺结节性甲状腺肿的手术:复发性甲状腺肿手术的特殊考虑]。

R A Wahl, A Hilpisch, P Vietmeier, J Schabram
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引用次数: 0

摘要

手术适应症需要个体风险分析。单侧手术更保守,全肺叶切除术更激进。最关键的风险是喉返神经麻痹(r.l.n.p.)。在1985-2001年的434例手术中,647条神经有危险,我们对神经的解剖情况进行了前瞻性分类:X:未识别,A:不在瘢痕内,B:在瘢痕内(B1, B2和B3背侧,外侧或腹侧)。从A型到B型再到X型,从B1型到B3型,r.l.n.p.的风险增加。此外,到目前为止,术中神经监测并没有降低这种风险。
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[Surgery of euthyroid nodular goiter: special considerations in surgery of recurrent struma].

Indications for surgery need individual risk-analysis. Operative strategy is more conservative with unilateral procedures, more radical with total lobectomy. The crucial risk is recurrent laryngeal nerve paralysis (r.l.n.p.). In 434 operations with 647 nerves at risk (1985-2001) we classified the anatomical situation of the nerve prospectively: X: not identified, A: not in scar and B: within scar (B1, B2 and B3 dorsally, laterally or ventrally). The risk of r.l.n.p. increased from types A to type B to X, and from B1 to B3. Up to now, intraoperative neuromonitoring did not reduce this risk, additionally.

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[120th Congress of the German Surgical Society. 29 April-2 May 2003, Munich, Germany. Abstracts]. [Clinical application--suture materials]. [Inguinal hernia: TAPP--future standard?]. [Preservation of the recurrent laryngeal nerve]. [Surgery of euthyroid nodular goiter: special considerations in surgery of recurrent struma].
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