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无瓣常规甲状腺切除术:一项前瞻性、随机研究。

Flapless conventional thyroidectomy: a prospective, randomized study.

机构信息

Department of General Surgery, Izmir Ataturk Training and Research Hospital, 35360, Basinsitesi, Izmir, Turkey.

出版信息

Surg Today. 2010 Nov;40(11):1018-22. doi: 10.1007/s00595-009-4186-3. Epub 2010 Nov 3.

DOI:10.1007/s00595-009-4186-3
PMID:21046498
Abstract

PURPOSE

Conventional thyroid surgery is one of the most common operations performed worldwide. The conventional technique involves placement of small or large cutaneous flaps. However, the published data regarding flap use for thyroidectomy are contradictory. This study presents the results using a flapless conventional thyroidectomy and the efficacy of this approach in a thyroidectomy. In addition, the study determined whether there are any advantages associated with the use of this approach in comparison to conventional thyroid surgery.

METHODS

One hundred and forty-two patients underwent a thyroidectomy. The patients were randomly assigned to surgical procedures. Patients in Group 1 (n = 70) underwent a conventional thyroidectomy, and patients in Group 2 (n = 70) underwent a conventional thyroidectomy without a cutaneous flap.

RESULTS

There was no significant difference between the two groups in terms of age, sex, body mass index, length of incision, gland volume, and length of hospital stay. Postoperative pain was significantly less in Group 2 than in Group 1 (P = 0.006). Patients in Group 2 showed significantly lower requirement for postoperative intravenous analgesic (P = 0.001), and postoperative peroral analgesic (P = 0.023) in comparison to those in Group 1. Incidences of transient vocal cord paralysis and hypocalcemia were 1.4% and 1.4%, respectively. Of 140 patients, 5 (3.6%) developed postoperative wound complications.

CONCLUSIONS

These results indicate that a flapless thyroidectomy is safe and technically feasible, and therefore could be an alternative to a conventional thyroidectomy.

摘要

目的

传统甲状腺手术是全球最常见的手术之一。传统技术涉及小皮瓣或大皮瓣的放置。然而,关于甲状腺切除术皮瓣使用的发表数据存在矛盾。本研究介绍了无皮瓣常规甲状腺切除术的结果及其在甲状腺切除术中的效果。此外,该研究确定了与传统甲状腺手术相比,使用这种方法是否有任何优势。

方法

142 名患者接受了甲状腺切除术。患者被随机分配到手术程序中。第 1 组(n = 70)的患者接受了常规甲状腺切除术,第 2 组(n = 70)的患者接受了无皮瓣的常规甲状腺切除术。

结果

两组在年龄、性别、体重指数、切口长度、腺体体积和住院时间方面无显著差异。第 2 组术后疼痛明显低于第 1 组(P = 0.006)。与第 1 组相比,第 2 组患者术后静脉内镇痛(P = 0.001)和术后口服镇痛(P = 0.023)的需求明显较低。暂时性声带麻痹和低钙血症的发生率分别为 1.4%和 1.4%。在 140 名患者中,有 5 名(3.6%)发生术后伤口并发症。

结论

这些结果表明,无皮瓣甲状腺切除术安全且技术可行,因此可能是传统甲状腺切除术的替代方法。

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本文引用的文献

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Endoscopic thyroidectomy and sentinel lymph node biopsy via an anterior chest approach for papillary thyroid cancer.经前胸入路内镜甲状腺切除术及甲状腺乳头状癌前哨淋巴结活检术
Surg Today. 2009;39(2):178-81. doi: 10.1007/s00595-008-3840-5. Epub 2009 Feb 7.
2
Complications of total thyroidectomy performed by surgical residents versus specialist surgeons.外科住院医师与专科外科医生实施全甲状腺切除术的并发症
Surg Today. 2008;38(10):879-85. doi: 10.1007/s00595-008-3760-4. Epub 2008 Sep 27.
3
Minimally invasive thyroid and parathyroid surgery is not a question of length of the incision.
影响甲状腺全切除术切口长度及手术时间的因素。
BMC Surg. 2012 Jul 31;12:15. doi: 10.1186/1471-2482-12-15.
微创甲状腺和甲状旁腺手术并非切口长度的问题。
Langenbecks Arch Surg. 2008 Sep;393(5):621-6. doi: 10.1007/s00423-008-0406-3. Epub 2008 Aug 21.
4
Minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study.微创视频辅助甲状腺切除术与传统甲状腺切除术:一项前瞻性随机研究。
Surg Endosc. 2008 Nov;22(11):2445-9. doi: 10.1007/s00464-008-9806-2. Epub 2008 Mar 6.
5
Electrocautery for cutaneous flap creation during thyroidectomy: a randomised, controlled study.甲状腺切除术中皮肤皮瓣制作的电灼术:一项随机对照研究。
J Laryngol Otol. 2008 Dec;122(12):1343-8. doi: 10.1017/S0022215108001734. Epub 2008 Mar 3.
6
Cosmetic thyroid surgery: defining the essential principles.美容甲状腺手术:界定基本原则
Laryngoscope. 2007 Jul;117(7):1168-72. doi: 10.1097/MLG.0b013e318053db8f.
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Minimally invasive video-assisted thyroidectomy for follicular neoplasm: is there an advantage over conventional thyroidectomy?微创视频辅助甲状腺切除术治疗滤泡性肿瘤:与传统甲状腺切除术相比有优势吗?
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