Thomas Jefferson University, Department of Otolaryngology - Head and Neck Surgery, Philadelphia, PA 19107, USA.
Med Sci Monit. 2011 Feb;17(2):SC7-10. doi: 10.12659/msm.881377.
Minimally invasive thyroidectomy (MIT) has gained popularity in the surgical management of benign and malignant pathology of the thyroid. One of the main benefits of utilizing this technique is the use of smaller incisions resulting in increased cosmetic satisfaction. Unfortunately, the retraction required for adequate exposure during MIT may lead to skin damage, impaired wound healing and poor cosmetic outcomes. Some have proposed that excising incision edges prior to closure may improve cosmesis. A review of the literature does not reveal any histologic evidence to support this technique.
MATERIAL/METHODS: In this prospective observational study, nine subjects undergoing MIT were identified. Both the superior and inferior skin edges were excised and labeled for orientation. Specimens were sent for hematoxylin and eosin staining and histologic analysis by a staff pathologist.
All specimens showed no significant findings such as damage to the architecture of the dermis, acute inflammation, edema or evidence of hemorrhage. Focal blood vessel ectasia within the dermis was identified in three of nine subjects.
Our findings do not yield a histological basis supporting the routine trimming of incisions during MIT. Although no significant findings were noted histologically, further studies are warranted to investigate the long-term cosmetic outcome of MIT incisions.
微创甲状腺切除术（MIT）在甲状腺良恶性病变的外科治疗中越来越受欢迎。使用这种技术的主要好处之一是使用较小的切口，从而提高美容满意度。不幸的是，MIT 过程中为了充分暴露而进行的牵拉可能导致皮肤损伤、伤口愈合受损和美容效果不佳。有人提出，在关闭切口之前切除切口边缘可能会改善美容效果。但文献回顾并未发现任何支持这种技术的组织学证据。
材料/方法：在这项前瞻性观察研究中，确定了 9 名接受 MIT 的患者。上下皮肤边缘均被切除并标记以定向。标本由一名病理科医生进行苏木精和伊红染色和组织学分析。
所有标本均未见明显异常，如真皮结构损伤、急性炎症、水肿或出血迹象。在 9 名患者中的 3 名中发现真皮内小血管扩张。
我们的研究结果没有提供组织学依据支持 MIT 过程中常规修剪切口。尽管组织学上未发现明显异常，但仍需要进一步研究来探讨 MIT 切口的长期美容效果。
