Dobrinja Chiara, Trevisan Giuliano, Liguori Gennaro
Department of General and Thoracic Surgery, Division of Clinical Surgery, Hospital of Cattinara, Università degli Studi di Trieste, Trieste, Italy.
Langenbecks Arch Surg. 2009 Mar;394(2):273-7. doi: 10.1007/s00423-008-0325-3. Epub 2008 May 28.
The aim of this study is to analyze our preliminary results from minimally invasive video-assisted thyroidectomy (MIVAT) and demonstrate the feasibility of MIVAT also in non-referral centers.
We report our initial experience based on a series of 47 patients selected for MIVAT at General Surgery Department of University of Trieste during a period from May 2005 to February 2007. The eligibility criteria were rigorously observed. Age, goiter volume, major diameter of the dominant nodule, operative times, pathologic findings, postoperative pain, length of hospital stay, cosmetic results, and complications were retrospectively analyzed.
Thyroid lobectomy was successfully accomplished in 33 cases, total thyroidectomy in 14. Conversion to standard cervicotomy was required in three patients (6%). Mean operative time of lobectomy was 82.6 min and 118.7 for total thyroidectomy. Postoperative complications included 11 (23.4%) transient hypocalcemias, 2 (4.2%) hematomas, and 2 (4.2%) temporary laryngeal nerve palsies. None-recurrent nerve palsies was observed. The cosmetic result was excellent in most cases.
Our experience demonstrates that MIVAT, after adequate training, is feasible and safe, with results comparable to conventional thyroidectomy, also in a General Surgery Department, from a dedicated team, with a sufficient and specific activity volume.
本研究旨在分析我们在微创视频辅助甲状腺切除术(MIVAT)方面的初步结果,并证明MIVAT在非转诊中心的可行性。
我们报告了2005年5月至2007年2月期间在的里雅斯特大学普通外科为47例选择进行MIVAT的患者的初始经验。严格遵守入选标准。对年龄、甲状腺肿体积、优势结节的最大直径、手术时间、病理结果、术后疼痛、住院时间、美容效果和并发症进行了回顾性分析。
33例成功完成甲状腺叶切除术,14例完成全甲状腺切除术。3例患者(6%)需要转为标准颈部切开术。甲状腺叶切除术的平均手术时间为82.6分钟,全甲状腺切除术为118.7分钟。术后并发症包括11例(23.4%)短暂性低钙血症、2例(4.2%)血肿和2例(4.2%)暂时性喉返神经麻痹。未观察到永久性喉返神经麻痹。大多数病例的美容效果极佳。
我们的经验表明,经过充分培训后,MIVAT是可行且安全的,其结果与传统甲状腺切除术相当,即使在普通外科,由一个专业团队进行,且有足够的特定手术量时也是如此。