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J Zhejiang Univ (Med Sci)  2021, Vol. 50 Issue (6): 701-706    DOI: 10.3724/zdxbyxb-2021-0341
    
The steps and key points of thyroid surgery with lateral cervical incision
WU Yijun1,*,ZHU Feng1,SHEN Yibin1,FANG Yun1,ZHU Lixian1,HE Qiwen1,PAN Jun1,CHEN Linghui1,TIAN Wen2
1. Department of Thyroid Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China;
2. Department of Thyroid and Hernia Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
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Abstract  

The thyroid surgery with lateral cervical incision uses the sternocleidomastoid intermuscular approach through the gap between band muscles and carotid sheath to reach the surgical field. The recurrent laryngeal nerve and upper and lower parathyroid glands are first identified, the upper pole vessels are severed; then the Berry ligament is separated; the isthmus is severed, and the thyroid gland is finally removed. This approach can avoid the trauma of the skin and muscle tissue in the anterior neck region, to relieve the pressure on the neck and swallowing stretch feeling for patients after surgery. The surgical modality is effective and less time-consuming. This article gives a detailed introduction to the standardized procedures and some key points of thyroid surgery with lateral cervical incision.



Key wordsLateral cervical incision      Sternocleidomastoid intermuscular approach      Thyroid surgery      Anterior cervical function protection      Surgery points     
Received: 07 October 2021      Published: 22 March 2022
Corresponding Authors: WU Yijun   
Cite this article:

WU Yijun,ZHU Feng,SHEN Yibin,FANG Yun,ZHU Lixian,HE Qiwen,PAN Jun,CHEN Linghui,TIAN Wen. The steps and key points of thyroid surgery with lateral cervical incision. J Zhejiang Univ (Med Sci), 2021, 50(6): 701-706.

URL:

https://www.zjujournals.com/med/10.3724/zdxbyxb-2021-0341     OR     https://www.zjujournals.com/med/Y2021/V50/I6/701


颈侧方切口甲状腺手术的步骤及要点

颈侧方切口甲状腺手术采用颈侧方切口,利用胸锁乳突肌胸骨头与锁骨头肌间的天然解剖间隙作为入路,从带状肌与颈动脉鞘之间进入甲状腺术区,首先辨识喉返神经及上下位甲状旁腺,离断上极血管,再分离Berry韧带,离断峡部,最后切除甲状腺。该手术可以避免传统手术对颈前区皮肤肌肉组织的创伤,患者术后颈部压迫感和吞咽牵拉感明显缓解。颈侧方切口甲状腺手术操作快捷,临床效果良好。本文介绍如何规范化地操作及手术注意事项等,以期更好普及推广。


关键词: 颈侧方切口,  胸锁乳突肌肌间入路,  甲状腺手术,  颈前区功能保护,  手术要点 
Figure 1 Incision marking and postoperative healing appearance of the sternocleidomastoid intermuscular approach of thyroid surgery with lateral cervical incision
Figure 2 Establishment of the surgical approach space during the thyroid surgery with lateral cervical incision
Figure 3 The location and separation of the recurrent laryngeal nerve during the thyroid surgery with lateral cervical incision
Figure 4 Treatment of the upper pole during the thyroid surgery with lateral cervical incision
Figure 5 Treatment of Berry’s ligament and anterior laryngeal area during the thyroid surgery with lateral cervical incision
Figure 6 Treatment of the inferior pole of the thyroid and isthmus dissection during the thyroid surgery with lateral cervical incision
Figure 7 Central lymph node dissection during the thyroid surgery with lateral cervical incision
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