2.0 版微创视频辅助甲状腺切除术：在一家三级癌症治疗中心的扩展适应证。
Minimally invasive video-assisted thyroidectomy 2.0: expanded indications in a tertiary care cancer center.
机构信息
Head and Neck Service, Department of Surgery, Memorial-Sloan Kettering Cancer Center, New York, New York, USA.
出版信息
Head Neck. 2011 Nov;33(11):1557-60. doi: 10.1002/hed.21633. Epub 2010 Dec 28.
BACKGROUND
Minimally invasive video-assisted thyroidectomy (MIVAT) advantages include a smaller incision, less extensive surgical dissection, improved visualization secondary to rigid fiberoptics, and decreased postoperative pain. The aims of our study were to report our experience using expanded indications of MIVAT.
METHODS
A retrospective chart review of a single surgeon's initial experience was carried out at a tertiary academic cancer center.
RESULTS
In all, 53 patients were identified, of whom 40 underwent total thyroidectomy and 13 underwent hemithyroidectomy. Thyroid volume, nodule size, incision length, and surgical time were all examined. Most common pathology was well-differentiated papillary thyroid cancer (69.8%): 42% of patients had evidence of thyroiditis found on pathology; 17% of patients had temporary vocal cord paralysis, with only 1 case of vocal cord paralysis persisting >6 months (1.9%). Six patients (11%) experienced temporary hypocalcemia, requiring postoperative calcium supplementation; no patients experienced permanent hypocalcemia.
CONCLUSIONS
The use of MIVAT with expanded indications shows complication rates comparable to those of traditional open thyroidectomy.
背景
微创视频辅助甲状腺切除术（MIVAT）的优点包括切口更小、手术解剖范围更小、刚性纤维光学改善了可视化效果、术后疼痛减轻。我们研究的目的是报告使用 MIVAT 扩展适应证的经验。
方法
在一家三级学术癌症中心，对一位外科医生的初始经验进行了回顾性图表审查。
结果
共确定了 53 名患者，其中 40 名患者接受了全甲状腺切除术，13 名患者接受了甲状腺叶切除术。检查了甲状腺体积、结节大小、切口长度和手术时间。最常见的病理学是分化良好的甲状腺乳头状癌（69.8%）：42%的患者在病理学上发现有甲状腺炎证据；17%的患者出现暂时性声带麻痹，仅有 1 例声带麻痹持续>6 个月（1.9%）。6 名患者（11%）发生暂时性低钙血症，需要术后补钙；无永久性低钙血症发生。
结论
MIVAT 扩展适应证的使用显示其并发症发生率与传统开放甲状腺切除术相当。
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