Yeh Michael W, Sidhu Stan B, Sywak Mark, Edhouse Pamela, Delbridge Leigh W
Department of Surgery, University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia.
ANZ J Surg. 2006 May;76(5):332-4. doi: 10.1111/j.1445-2197.2006.03720.x.
Minimal access thyroid surgery (MATS), carried out through a lateral 2.5-cm incision, provides excellent clinical and cosmetic outcomes when carried out for small (<3 cm), single nodules. However, if the final pathology shows thyroid malignancy and a completion thyroidectomy is required, the small lateral incision requires conversion to a standard collar incision and the second operation must be carried out in the presence of previous lateral dissection. The aim of this study is to determine if there is any demonstrable disadvantage to completion thyroidectomy for malignancy after MATS when compared with the same procedure after conventional hemithyroidectomy.
This retrospective cohort study examined all patients undergoing completion thyroidectomy for malignancy in the University of Sydney Endocrine Surgical Unit from January 2002 to January 2005. Outcome measures were complication rates, final scar length and patient's self-assessment of scar appearance.
A total of 106 patients underwent MATS during the study period, 11 of whom required completion thyroidectomy for malignancy. During the same period, 42 patients required completion thyroidectomy for malignancy after previous conventional hemithyroidectomy. There was no difference in complication rates between the two groups. The two complications in the study consisted of one case of flap oedema (control) and one case of keloid scar (MATS). Mean final incision length, scar appearance and patient's satisfaction with scar did not differ between the two groups.
There is no demonstrable disadvantage when completion thyroidectomy for malignancy is required after MATS.
微创甲状腺手术（MATS）通过2.5厘米的外侧切口进行，对于小的（<3厘米）单个结节而言，在临床和美容效果方面表现出色。然而，如果最终病理显示为甲状腺恶性肿瘤且需要进行甲状腺全切术，那么这个小的外侧切口需要转换为标准的领口切口，并且第二次手术必须在先前外侧解剖的情况下进行。本研究的目的是确定与传统甲状腺半切术后进行相同手术相比，MATS术后因恶性肿瘤进行甲状腺全切术是否存在任何明显的劣势。
这项回顾性队列研究检查了2002年1月至2005年1月在悉尼大学内分泌外科接受因恶性肿瘤进行甲状腺全切术的所有患者。观察指标为并发症发生率、最终瘢痕长度以及患者对瘢痕外观的自我评估。
在研究期间，共有106例患者接受了MATS，其中11例因恶性肿瘤需要进行甲状腺全切术。同期，42例患者在先前进行传统甲状腺半切术后因恶性肿瘤需要进行甲状腺全切术。两组之间的并发症发生率没有差异。研究中的两例并发症包括1例皮瓣水肿（对照组）和1例瘢痕疙瘩（MATS组）。两组之间的平均最终切口长度、瘢痕外观以及患者对瘢痕的满意度没有差异。
当MATS术后因恶性肿瘤需要进行甲状腺全切术时，没有明显的劣势。
