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宫颈内镜手术的最新进展。

Update on endoscopic cervical surgery.

作者信息

Miccoli Paolo, Materazzi Gabriele

机构信息

Department of Surgery, University of Pisa, Pisa, Italy.

出版信息

Semin Laparosc Surg. 2004 Sep;11(3):139-45. doi: 10.1177/107155170401100303.

Abstract

The onset of cervicoscopy dates back to the first laparoscopic parathyroidectomy in 1996. This operation, with its several variants, has today become a valid option that is widespread in many centers. Endoscopic or video-assisted thyroidectomy was introduced later, despite the limits imposed by the mass of the gland to be removed. Even though it was indicated for a minority of patients for this reason, both parathyroidectomy and thyroidectomy showed some important advantages with respect to conventional surgery, advantages that were also demonstrated in prospective studies that include a better cosmetic outcome and a less distressful postoperative course. These approaches proved to be safe and feasible in any surgical background, and their complication rate is the same as traditional open neck surgery. The videoscopic access to neck lymph nodes (central and lateral compartments) seems to be very promising, whereas other fields of application such as carotid artery surgery and spine surgery are still being studied experimentally. Cervicoscopy by consequence has to be considered an important surgical tool that can be further improved but which also has an excellent potential.

摘要

宫颈镜检查的起源可追溯到1996年的首例腹腔镜甲状旁腺切除术。这种手术及其多种变体,如今已成为许多中心广泛采用的一种有效选择。内镜或视频辅助甲状腺切除术随后被引入,尽管存在需要切除的腺体体积所带来的限制。尽管由于这个原因它仅适用于少数患者,但甲状旁腺切除术和甲状腺切除术相对于传统手术都显示出一些重要优势,这些优势在前瞻性研究中也得到了证实,包括更好的美容效果和术后痛苦较小的病程。这些方法在任何手术背景下都被证明是安全可行的,并且它们的并发症发生率与传统的开放性颈部手术相同。视频辅助进入颈部淋巴结(中央和外侧区域)似乎非常有前景,而其他应用领域,如颈动脉手术和脊柱手术仍在进行实验研究。因此,宫颈镜检查必须被视为一种重要的手术工具,它可以进一步改进,并且具有巨大的潜力。

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