Video-assisted neck surgery を用いた甲状腺切除術の経験

Endoscopic surgery has been applied in various surgical fields because of its low invasiveness and lack of adverse cosmetic effects. Recently, applications of this technique to neck surgery have been reported with success.We performed an endoscopic operation on the thyroid in 3 patients with thyroid nodules by videoassisted neck surgery (VANS) using an anterior neck lift method. The region 10cm below the clavicle was selected for the initial approach to the thyroid,where neck cloths could be used. An additional lymph node dissection in the pre-and para-trachea was prophylactically performed in one patient, as the cytodiagnosis before surgery and the gross findings during operation regarding the thyroid nodule in this patient showed a possibility of follicular neoplasm. The size of the resected nodule was from 1.2 to 4.4cm (mean:3.0cm.), the operating time from 250 to 287min. (mean: 273min.), the amount of operative bleeding from 20 to 530ml. (mean:216.4ml.)and postoperative hospital stay from 6 to 8 days (mean:6.7 days).No complications after the surgery were recorded in any patients. It seems likely that the time and the amount of bleeding in VANS depend on the location or size of the nodule as well as the operative procedure.However,these problems could be solved with further experience.We believe that VANS will be of great use as an alternative to open neck surgery in patients with benign thyroid nodule, parathyroid adenoma, Graves disease or thyroid microcarcinoma with minimal invasion.Article信州医学雑誌 48(1): 15-20(2000)journal articl

原発性上皮小体機能亢進症における術後偽痛風発作の臨床的検討

Article信州医学雑誌 45(4): 289-292(1997)journal articl

Explosion of the Education Program to Support Nurses who Engage in Emergency Care under Niigata Prefecture

平成14年から15年にかけて,われわれが行った新潟県下の救急看護に従事する看護者の看護実践能力に関する調査研究をもとに,救急看護に従事する看護者を支援するための教育プログラムを作成するための基礎調査として第3次救急医療機関(以下3次医療機関)および上越地域における第2次救急医療機関(以下2次医療機関)の施設内救急看護教育の現状を調査した.3次医療機関においては,施設内における救急看護基礎教育が定着しており,さらに周辺地域への教育の普及という地域の基幹病院としての役割を認識した教育も行われていた.上越市内の2次医療機関においては,施設間で救急看護教育の状況に大きくバラつきが見られた.また,2次医療機関,3次医療機関ともに教育を実施していく上で時間や人員,設備等の資源の充足や確保が大きな課題となっていた.今後,特に上越地域の2次救急医療機関のニーズを検討しながら共に救急看護教育をサポートできるプログラム作成を行っていく必要があることが示唆された.departmental bulletin pape