Seybt M W, Terris D J
Department of Otolaryngology, Head and Neck Surgery, Medical College of Georgia, Augusta, GA 30912-4060, USA.
Minerva Chir. 2010 Feb;65(1):39-43.
The aim of this paper was to explore the appropriateness and outcomes of minimally invasive thyroid surgery for the management of well-differentiated thyroid cancer. The study is a planned analysis of a prospectively maintained patient database representing a consecutive, single-surgeon experience. A systematic review was undertaken of a series of patients undergoing minimally access surgery for well-differentiated thyroid cancer. Comprehensive demographic data were considered, including age, gender, pathologic findings, complications, and oncologic outcomes. Ninety-two patients with thyroid cancer (mean age =45.6 years) underwent minimally invasive or endoscopic thyroidectomy over a five-year period. Surgical pathology revealed papillary cancer in 76 patients, follicular cancer in 10 patients, Hurthle cell cancer in 3 patients and medullary cancer in 3 patients. There have been no recurrences in any of these patients thus far (with a short median follow-up of 31 months). Excellent cosmetic results have been observed with this minimal access approach. Minimally invasive and endoscopic thyroidectomy can be safely and effectively performed in many patients with low- or intermediate-risk thyroid cancer. In addition to improved cosmesis, many patients experience decreased pain and faster recovery, and are at no increased risk for complications in the hands of high-volume thyroid surgeons.
本文旨在探讨微创甲状腺手术治疗分化型甲状腺癌的适宜性及疗效。该研究是对一个前瞻性维护的患者数据库进行的计划分析，该数据库代表了一位外科医生连续的手术经验。对一系列接受微创甲状腺手术治疗分化型甲状腺癌的患者进行了系统评价。考虑了全面的人口统计学数据，包括年龄、性别、病理结果、并发症和肿瘤学结局。92例甲状腺癌患者（平均年龄45.6岁）在5年期间接受了微创或内镜甲状腺切除术。手术病理显示，76例为乳头状癌，10例为滤泡状癌，3例为嗜酸性细胞癌，3例为髓样癌。迄今为止，这些患者均无复发（中位随访时间较短，为31个月）。采用这种微创方法观察到了极佳的美容效果。微创和内镜甲状腺切除术可在许多低危或中危甲状腺癌患者中安全有效地进行。除了改善美容效果外，许多患者疼痛减轻、恢复更快，并且在经验丰富的甲状腺外科医生手中并发症风险并未增加。
