Nenkov R, Radev R, Kuzmanov Ia, Kornovski S, Kuzmanov S, Nanev B, Khristozov K, Nenkova N
Khirurgiia (Sofiia). 2005(3):23-7.
The interest in the application of the minimally invasive procedures in the thyroid surgery vastly increased in recent years.
To present our experience with the application of minimally invasive nonendoscopic resections in the thyroid surgery.
145 patients with various thyroid diseases were operated on with minimally invasive open approach for the period from 1 Janyary 2003 to 30 June 2004 in our institution. Nodular thyroid pathology has dominated. All patients were females, mean age 28.5 years. An preoperative ultrasonographic assessment of thyroid volume, nodular count, size and localization was performed in all cases. The mean thyroid lobe volume was 11.2 ml the size of the removed thyroid nodules was 9 to 33mm (21 +/- 12 mm). The incision length was measured at the beginning, at the end and one week after the operation.
The extent of thyroid resection was as follows: partial thyroid resection of a lobe in 28 patients; bilateral partial thyroid resection in 16 patients; subtotal lobectomy in 35 patients; lobectomy in 50 patients; lobectomy with partial thyroid resection of the other lobe in 8 patients; subtotal thyroidectomy in 5 patients; thyroidectomy in 3 patients. The incision length at the end of operation was 3.0 +/- 0.5 cm. Mean operative time was 41.5 +/- 8.4 min. The postoperative hospital stay was 24 +/- 6 hours. Postoperative complications were not observed, except a little haematoma in one case at the beginning of the study, that did not required any additional intervention. The early and late postoperative cosmetic results we have observed, were undoubtedly better.
Our experience demonstrates that miniinvasive nonendoscopic thyroid resections represent a simple, safe and feasible surgical procedure in selected patients with small to middle-size thyroid nodules.
近年来,甲状腺手术中微创技术应用的关注度大幅提高。
介绍我们在甲状腺手术中应用微创非内镜切除术的经验。
2003年1月1日至2004年6月30日期间,我院对145例患有各种甲状腺疾病的患者采用微创开放手术方法进行手术。以结节性甲状腺病变为主。所有患者均为女性,平均年龄28.5岁。所有病例均进行了术前甲状腺体积、结节数量、大小及定位的超声评估。甲状腺叶平均体积为11.2 ml,切除的甲状腺结节大小为9至33 mm(21±12 mm)。在手术开始时、结束时及术后一周测量切口长度。
甲状腺切除范围如下:28例患者行一侧叶部分甲状腺切除术;16例患者行双侧部分甲状腺切除术;35例患者行次全叶切除术;50例患者行叶切除术;8例患者行一侧叶切除术并对另一侧叶进行部分甲状腺切除术;5例患者行次全甲状腺切除术;3例患者行甲状腺切除术。手术结束时切口长度为3.0±0.5 cm。平均手术时间为41.5±8.4分钟。术后住院时间为24±6小时。除研究开始时1例出现少量血肿且无需任何额外干预外,未观察到术后并发症。我们观察到的术后早期和晚期美容效果无疑更好。
我们的经验表明,微创非内镜甲状腺切除术对于选定的中小尺寸甲状腺结节患者而言是一种简单、安全且可行的手术方法。