Jung Eun-Jung, Park Soon-Tae, Ha Woo-Song, Choi Sang-Kyung, Hong Soon-Chan, Lee Young-Joon, Jeong Chi-Young, Joo Young-Tae, Moon Hyeong-Gon
Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University, Jinju, South Korea.
J Laparoendosc Adv Surg Tech A. 2007 Feb;17(1):21-5. doi: 10.1089/lap.2006.05112.
We have recently developed an endoscopic thyroidectomy using a gasless axillary approach and report the surgical outcome of the procedure.
The gasless axillary approach was performed through a 3-cm axillary incision using a retractor instead of carbon dioxide insufflation. We performed a total of 35 thyroidectomies using this technique in patients with benign thyroid nodules.
Thirty-four cases were successfully completed with the gasless axillary approach; one case had to be converted to a conventional technique after intraoperative frozen section revealed papillary carcinoma. The mean operative time and mean hospital stay were 180.6 +/- 54.5 minutes and 7.1 +/- 0.9 days, respectively. The mean tumor size was 2.9 +/- 1.4 cm. There were three minor postoperative complications: one case each of wound seroma, transient voice change, and persistent wound pain. All patients were satisfied with the cosmetic result. The axillary scars were not visible when the ipsilateral arms were in their natural position.
Endoscopic thyroidectomy using a gasless axillary approach is a safe procedure that offers a good cosmetic result and has the merits of minimal invasiveness even in patients with a large thyroid mass. It is a safe and feasible alternative to traditional thyroid surgery, especially in young female patients with a large thyroid mass.
我们最近开发了一种采用无气腋窝入路的内镜甲状腺切除术，并报告该手术的结果。
无气腋窝入路通过一个3厘米的腋窝切口进行，使用牵开器而非二氧化碳充气。我们使用该技术对患有良性甲状腺结节的患者共进行了35例甲状腺切除术。
34例患者通过无气腋窝入路成功完成手术；1例在术中冰冻切片显示为乳头状癌后不得不转为传统技术。平均手术时间和平均住院时间分别为180.6±54.5分钟和7.1±0.9天。平均肿瘤大小为2.9±1.4厘米。术后有3例轻微并发症：伤口血清肿、短暂声音改变和持续性伤口疼痛各1例。所有患者对美容效果满意。当患侧手臂处于自然位置时，腋窝疤痕不可见。
采用无气腋窝入路的内镜甲状腺切除术是一种安全的手术，具有良好的美容效果，即使对于甲状腺肿块较大的患者也具有微创的优点。它是传统甲状腺手术的一种安全可行的替代方法，尤其适用于年轻的甲状腺肿块较大的女性患者。
