Nenkov R, Radev R, Kuzmanov Ia, Kornovski S, Kuzmanov S, Khristozov K, Krasnaliev I
Khirurgiia (Sofiia). 2005(6):28-31.
A crescent number of reports concerning the use of minimally invasive approach in thyroid surgery arise in the last years.
This report describes the recently developed technique of minimally invasive open thyroidectomy and represents our initial experience.
Thirty seven patients underwent a minimally invasive open thyroidectomy in the Clinic of Thoracic Surgery, Medical University of Varna between February the 1th and May the 31th, 2003. Nodular thyroid diseases were the dominant cause. All patients were females. In all cases a preoperative ultrasonography was made to evaluate the volume of each thyroid lobe, as well as the number, size and location of the thyroid nodules.
The length of the skin incision varied from 2 to 3,5 cm. Operative time was at 45,4 +/- 10,3 min. Postoperative hospital stay was at 24 +/- 8 hours. There were not any postoperative complications. The extent of thyroid resections was as follows: partial lobe resection in 6 patients; lobectomy in 16 patients; lobectomy and partial counter lateral lobe resection in 4 patients; lobectomy with subtotal thyroidectomy of the other lobe in 2 patients and thyroidectomy in 1 patient. The cosmetic results we have observed were undoubtedly better.
Although initial, our experience shows that minimally invasive open thyroidectomy provides surgeons with an adequate operative field, and that it has proven to be simple, safe, quick and practical for selected patients with small to middle sized thyroid nodules.
近年来,有关在甲状腺手术中使用微创方法的报道数量呈上升趋势。
本报告描述了最近开发的微创开放性甲状腺切除术技术,并介绍了我们的初步经验。
2003年2月1日至5月31日期间,37例患者在瓦尔纳医科大学胸外科诊所接受了微创开放性甲状腺切除术。结节性甲状腺疾病是主要病因。所有患者均为女性。所有病例术前均进行超声检查,以评估每个甲状腺叶的体积以及甲状腺结节的数量、大小和位置。
皮肤切口长度为2至3.5厘米。手术时间为45.4±10.3分钟。术后住院时间为24±8小时。无任何术后并发症。甲状腺切除范围如下:6例患者行部分叶切除术;16例患者行叶切除术;4例患者行叶切除术及部分对侧叶切除术;2例患者行叶切除术及另一叶次全甲状腺切除术;1例患者行甲状腺切除术。我们观察到的美容效果无疑更好。
尽管是初步经验,但我们的经验表明,微创开放性甲状腺切除术为外科医生提供了足够的手术视野,并且已证明对选定的中小尺寸甲状腺结节患者来说简单、安全、快速且实用。