科室简介：　　血管甲状腺腹壁疝外科随着我国人民生活水平的普遍提高和老年人群数量的增多，血管疾病的发病率明显增多，各医学专科的分工也越来越细，为适应社会的需求，广东省人民医院于2007年成立了血管甲状腺腹壁疝外科。使我院普通外科在原有框架下形成了以血管甲状腺腹壁疝外科、肝胆胰外科、胃肠外科三个专科分工协作、齐头并进的新局面。

　　一、专科特色

　　1. 血管外科是外科领域的一门年轻的新兴学科，我国目前主动脉与周围血管疾病的发病率急剧上升，病种发生明显变化，严重影响病人的生活质量，部分患者致残、甚至危及生命。近年随着新的科学技术的提高，血管外科进入了一个迅猛发展的阶段，血管甲状腺腹壁疝外科先后开展外科手术结合腔内血管支架治疗腹主动脉瘤、主动脉夹层等，同时开展了各种周围动脉瘤、肾动脉狭窄、动脉硬化闭塞症、动静脉瘘的腔内血管支架治疗。现在腔内血管外科已成为我科的一常规治疗手段，使血管外科的巨创手术变成微创手术。静脉疾病方面我们在省内率先开展了下肢静脉曲张的刨吸治疗，使该病治疗效果与美观性大大提高。除了开展血管腔内治疗等微创手术外，常规血管手术也得到充分提高，如复杂胸腹主动脉瘤切除人工血管置换术、各种动脉闭塞症的血管搭桥术、动脉瘤切除、动静脉瘘切除血管重建术等，使很多患者免除了截肢的痛苦，挽救了大量患者生命。目前科室在彭林主任带领下成为集血管腔内介入治疗、外科手术和规范用药等全面综合发展壮大的优秀团队，拥有临床经验丰富、技术力量雄厚、医疗水平高超的现代化医学学科。

　　目前科室治疗的血管疾患主要包括：1.动脉扩张性疾病：腹主动脉瘤，主动脉夹层动脉瘤，各种周围动脉瘤，如颈动脉瘤、腋动脉瘤、股动脉瘤、腘动脉瘤、内脏动脉瘤等；2．动脉闭塞性疾病： 慢性肢体动脉闭塞性疾病，如血栓闭塞性脉管炎、下肢动脉硬化性闭塞症、糖尿病性的肢体动脉闭塞症（糖尿病足），急性动脉栓塞或血栓形成，颅外颈动脉狭窄，雷诺氏症等；3．静脉疾患：深静脉血栓形成及深静脉血栓后遗症，下肢浅静脉曲张，血栓性浅静脉炎，深静脉瓣膜功能不全，布加氏综合征，髂静脉受压综合征等；4．血管损伤：血管损伤所致的动静脉瘘、假性动脉瘤等；5．侵及大血管的晚期肿瘤的根治性切除+血管重建术；6．各种血管畸形：蔓状血管瘤，先天性动静脉瘘，静脉畸形肢体肥大综合征等。

　　2 甲状腺疾病的综合治疗是血管甲状腺腹壁疝外科的又一亮点，科室平均每天完成甲状腺手术5-7台，按照统一临床治疗路径规范化地处理各种甲状腺疾病，如结节性甲状腺肿、甲状腺腺瘤、甲亢及甲状腺癌等。微创技术条件下的甲状腺手术是我科的特色：开放手术时采用的微创技术使手术时间明显缩短、术中基本无出血、术后并发症极少，对所有病人均采用颈部低位、沿皮纹切口，并做美容缝合，愈合后瘢痕非常轻微；在超声科的协助下，我科开展了甲状腺结节的射频治疗，真正达到消除甲状腺肿物于无形；同时腔镜辅助下甲状腺手术也是我院的特色之一，使手术切口更加隐蔽。科室还开展了甲状旁腺手术治疗，获得了很好的手术效果。目前血管甲状腺腹壁疝外科甲状腺疾病的微创治疗、甲状腺癌的规范化综合治疗等方面达到国内领先水平。

　　3 血管甲状腺腹壁疝外科已经形成华南地区最大的疝外科治疗中心，我们的特色是个体化治疗与微创理念相结合，可以做到“局麻手术、当天入院、当天手术、24h出院”。达到疗效好、痛苦小、恢复快、禁忌少的目的。局麻下个体化无张力修补、腹腔镜下各种疝修补手术、复杂疝的综合治疗等是我科优势。其中现代疝外科的个体化治疗水平与国际接轨，科内专家多次在国内外进行手术演示与教学。同时为了提高国内同行疝的治疗水平，多次举办国家级疝治疗学习班。

　　4 同时血管甲状腺腹壁疝外科开展后腹膜肿瘤的治疗，主要是针对后腹膜的各种良性、恶性肿瘤的综合治疗，包括手术治疗和化疗、放疗以及生物免疫治疗等；

　　5 兼顾肝胆胃肠疾病的诊断治疗，特别是消化系统肿瘤方面是我科的传统优势之一。在胃肠肿瘤的微创治疗、肝胆疾病的综合治疗等方面有丰富的经验和很好的疗效。

　　二 科室概况：
　　血管甲状腺腹壁疝外科目前病床40张，年平均手术达到1700台以上。目前有医生11人，其中高级职称6人、中级职称3人、初级职称2人；其中博士学历4人，硕士学历4人；护理人员16人；目前硕士研究生导师2人。本科室拥有一批在本专业拥有建树的外科专家和学者，以及专业技术精良的护理队伍。承担着普通外科专业的临床、科研和教学任务，是国家级继续教育学习班的承办单位、卫生部临床专科医师培训基地、国家药监局临床药物试验基地。近年来，血管甲状腺腹壁疝外科建立了自己的数据资料库，实现了电子化数据整合及数据库与影像资料库的建设，建立了一整套完整可信的医学资料库，为临床数据统计与分析和将来的临床科研工作奠定了扎实的基础。

　　血管甲状腺腹壁疝外科的全体医务人员将以更专业的技术和理念以及更人性化的服务为广大患者带来康复。

　　Guangdong General Hospital (Guangdong Academy of Medical Sciences)
Introduction to Department of General Surgery of Vascular Disease, Thyroid Gland and Hernia
With the improvement of our living standards and the increase of the number of elder population, the incidence of vascular disease increased significantly, and various medical specialties have been breaking down more elaborately. In order to meet the demand of our society, Department of General Surgery of Vascular Disease, Thyroid Gland and Hernia was founded in 2007 in Guangdong General Hospital, which transformed the original framework of our General Surgery Department into a new one with three specialties collaborating and working together in terms of General Surgery of Vascular Disease, Thyroid Gland and Hernia, Hepatobiliary and Pancreatic Surgery and Gastrointestinal Surgery.
一、characteristics of the specialties
1. Vascular surgery is an emerging discipline in the sugery field. Currently, the incidence rate of arota and peripheral vascular diseases is sharply increasing and the disease types has changed significantly in China, which seriously affects the life quality of patients, making them maimed or even threatening their life. In recent years, with the advance of new science and technology, vascular surgery enters into a stage of rapid development. In the Department of General Surgery of Vascular Disease, Thyroid Gland and Hernia, Surgical treatments combined with endovascular stents are performed to treat abdominal aortic aneurysm, aortic dissection, and etc, while endovascular stents are used to treat various peripheral artery aneurysm, renal artery stenosis, arteriosclerosis obliterans, arteriovenous fistula. Now, endovascular surgery has become routine treatment in our department, which transformed the vascular surgery into a minimally invasive surgery. As for venous diseases, we are the first to treat varicose veins of the lower extremities with transilluminated powered phlebectomy (TriVex), which greatly improves the treatment efficacy and aesthetics of the disease. In addition to minimally invasive surgeries like endovascular treatment, conventional vascular surgeries has also been fully improved, such as abdominal aortic aneurysm resection and artificial vascular replacement, vessel bypass for arterial occlusive disease, resection of aneurysm, arteriovenous fistula resection and revascularization, which prevent the patients from suffering amputations and has saved a lot of lives. Under the leadership of Professor Peng Lin, the department has become an excellent group with rich clinical experience, strong technical force and superior medical treatment level.
2. Diseases treated in our department include: 1. Dilated artery disease: abdominal aortic aneurysm, dissecting aneurysm of aorta, and various peripheral aneurysms, such as carotid aneurysm, axillary aneurysm, femoral aneurysm, popliteal aneurysm, visceral aneurysms, and etc. 2. Arterial occlusive disease: chronic limb arterial occlusive diseases, such as vascular occlusion angeitides, arterial occlusive disease of low extremity, diabetic arterial occlusion of lower extremities, acute arterial occlusion or thrombosis, extracranial carotid artery stenosis, Raynauds syndrome, and etc. 3. Vein diseases: deep vein thrombosis and vein thrombosis sequela, varicose veins of lower extremities, superficial thrombotic phlebitis, primary deep vein insufficiency, Budd-Chiari' Syndrome, iliac vein compression syndrome, and etc. 4. Vascular injury: arteriovenous fistula and pseudoaneurysm caused by vascular injury, etc. 5. Radical resection of late-stage tumor invading great vessels and revascularization. 6. Vascular malformation: racemose hemangioma, congenital arteriovenous fistula, Klippel-Trénaunay syndrome, and etc.
Comprehensive treatment of thyroid diseases is another high point of General Surgery of Vascular Disease, Thyroid Gland and Hernia. There are average 5-7 thyroid operations performed in the department every day. Various kinds of thyroid diseases are given standardized treatment according to uniformed clinial paths, such as nodular goiter, thyroid adenoma, Hyperthyroidism, thyroid carcinoma. Thyroid operation with minimally invasive techniques is a distinguishing feature of our department. In open surgeries, application of minimally invasive technology can significantly shorten the operative time with almost no intraoperative bleeding and few post-operative complications. For all patients, Low Cervical Incision along the skin line is applied and cosmetic suture is performed, which results in minimal scar. With the assistance of Ultrasound Section, we carry out radiofrequency treatment of thyroid nodule, which can eliminate thyroid neoplasms with no trace. In addition, endoscopy-assisted thyroid operations is another characteristics of our department, which makes the incision more invisible. Moreover, our department also carry out surgical operations of parathyroid gland, achieving excellent surgical effect. Currently our department take the lead in minimally invasive treatment of thyroid and standardized comprehensive therapy of thyroid carcinoma in China.
3. Department of General Surgery of Vascular Disease, Thyroid Gland and Hernia has become the largest hernia surgery center in South China. Our feature is the combination of personalized treatment and minimally invasive concept. We promise that it would be a local anesthesia surgery operated on the admission day and the patients would be discharged after 24 hours, with good efficacy, little pain, quick discovery and few taboos. The strength of our department is in personalized tension-free inguinal hernia repair, laparoscopic hernia repair surgery and comprehensive treatment of complicated hernia. Our personalized treatment of modern hernia surgery can catch up with the international level. Experts in our department has given operation demonstration and teaching at home and abroad for many times. In order to improve the therapeutic level of our counterparts in treating hernia, we held many national hernia treatment training classes.
4. Treatment of retroperitoneal tumor is also carried out in the Department of General Surgery of Vascular Disease, Thyroid Gland and Hernia, mainly including comprehensive therapy of various benign and malignant retroperitoneal tumors, such as surgical treatment and chemotherapy, radiotherapy and biological immune therapy. 5. Our department also involves diagnosis and treatment of hepato-biliary and gastrointestinal diseases, especially digestive system tumor, which is one of the traditional strengths of our department. We also have rich experiences in minimally invasive treatment of gastrointestinal tumors and comprehensive treatment of hepato-biliary diseases and have achieved good efficacy.
2 profile of the department
There are 40 patient beds in the Department of General Surgery of Vascular Disease, Thyroid Gland and Hernia. The average operations performed every year are more than 1700 cases. In our department, there are 11 doctors, of which there are 6 with senior title, 3 with middle title, and 2 with primary title; of which there are 4 doctors and 4 masters. There are 16 nurses. And there are currently 2 master supervisors. We have a number of surgical specialists and scholars with great achievements and nursing group with excellent professional techniques in our department, who assume the clinical, research and teaching tasks of discipline of general surgery. Our department is the operator of national continuing education training classes, the clinical specialist training base of Ministry of Health, and National Base of Clinical Drug Trial. In recent years, our department established our own database, achieving the integration of electronic data and constructing image database, established a whole set of complete and credible medical information database, which lays a solid foundation for clinical data analysis and future clinical research.
All the staff in the Department of General Surgery of Vascular Disease, Thyroid Gland and Hernia would serve the patients with more professional techniques and concepts as well as more humanistic service to bring the health back to the patients.