Maeda Shigeto, Shimizu Kazuo, Minami Shigeki, Hayashida Naomi, Kuroki Tamotsu, Furuichi Akira, Sugiyama Nozomu, Ishigaki Katsu, Suto Ryuichiro, Furui Junichiro, Kanematsu Takashi
Division of Endocrine Surgery, Department of Surgery, Nagasaki University, Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8102, Japan.
Biomed Pharmacother. 2002;56 Suppl 1:92s-95s. doi: 10.1016/s0753-3322(02)00236-6.
Endoscopic surgery has now become a well-established modality for the treatment of various organ diseases. In the present study, we analyzed the surgical results achieved by video-assisted neck surgery (VANS) in thyroid and parathyroid diseases.
From January 2000 to April 2002, 87 patients (eight males and 79 females) with a mean age of 49 years underwent VANS. The preoperative diagnoses of these patients included 37 benign thyroid tumors, 30 Graves' diseases, 17 parathyroid adenomas and three thyroid cancers.
The mean operative time of VANS was 165 min for a hemithyroidectomy, 287 min for a subtotal thyroidectomy, and 157 min for a parathyroidectomy. The mean intraoperative blood loss was 60, 183 and 23 g for a hemithyroidectomy, subtotal thyroidectomy and parathyroidectomy, respectively. No conversion from VANS to conventional surgery was experienced. Three patients (3.4%) had temporary palsy of the recurrent laryngeal nerve. Otherwise, the postoperative courses were uneventful.
VANS for thyroid and parathyroid diseases was found to be safe and effective. From a cosmetic point of view, a high degree of patient satisfaction was obtained. VANS is thus considered to be an excellent option for selected patients with thyroid and parathyroid diseases.
内镜手术现已成为治疗各种器官疾病的成熟方式。在本研究中,我们分析了视频辅助颈部手术(VANS)治疗甲状腺和甲状旁腺疾病的手术结果。
2000年1月至2002年4月,87例患者(8例男性和79例女性)接受了VANS手术,平均年龄49岁。这些患者的术前诊断包括37例良性甲状腺肿瘤、30例格雷夫斯病、17例甲状旁腺腺瘤和3例甲状腺癌。
VANS的平均手术时间为:半甲状腺切除术165分钟,甲状腺次全切除术287分钟,甲状旁腺切除术157分钟。半甲状腺切除术、甲状腺次全切除术和甲状旁腺切除术的平均术中失血量分别为60、183和23克。没有发生从VANS转为传统手术的情况。3例患者(3.4%)出现喉返神经暂时性麻痹。除此之外,术后病程平稳。
发现VANS治疗甲状腺和甲状旁腺疾病是安全有效的。从美容角度来看,患者满意度很高。因此,VANS被认为是选定的甲状腺和甲状旁腺疾病患者的极佳选择。