Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea.
World J Surg. 2013 May;37(5):1147-53. doi: 10.1007/s00268-013-1934-8.
The bilateral axillo-breast approach for endoscopic/robotic thyroid surgery (BABA) shows good oncologic and surgical outcomes and does not result in neck scars. However, there is concern about potential sensory changes of the skin flaps after BABA, especially of the breast areas. This prospective study was undertaken to evaluate sensory changes in the skin flaps after BABA.
A total of 19 women (mean age 36.9 ± 8.7; age range 21-51 years) who underwent BABA were enrolled. Skin flap sensory assessments were performed for each patient preoperatively and again at 1 and 3 months postoperatively. The Semmes-Weinstein monofilament test was used to evaluate the cutaneous light-pressure thresholds, a biothesiometer was used to evaluate the vibration thresholds, and an infrared thermometer was used to measure skin temperatures of the skin flaps.
There were changes in the sensations of the anterior chest areas over time, as determined by the Semmes-Weinstein monofilament test (1.5 vs 4.3 versus 1.4; P < 0.05) and the biothesiometer (26.8 vs 31.2 vs 22.3; P < 0.05). The sensations in the anterior chest areas normalized to preoperative levels at 3 months postoperatively. No significant differences were seen in the infrared thermometer test at any of the time points (36.2 vs 36.2 vs 36.3 °C; P = 0.9927).
While anterior chest area sensations were changed at 1 month postoperatively, the sensations normalized at 3 months after BABA. These results suggest that BABA has minimal adverse effects on anterior chest area sensation.
内镜/机器人甲状腺手术的双侧腋窝-乳房入路(BABA)显示出良好的肿瘤学和手术效果,且不会导致颈部疤痕。然而,人们担心 BABA 后皮瓣的皮肤感觉会发生变化,特别是乳房区域。本前瞻性研究旨在评估 BABA 后皮瓣的感觉变化。
共纳入 19 名女性(平均年龄 36.9 ± 8.7 岁;年龄范围 21-51 岁)行 BABA。每位患者在术前和术后 1 个月、3 个月时进行皮瓣感觉评估。采用 Semmes-Weinstein 单丝试验评估皮肤轻触阈,采用生物感觉计评估振动阈,采用红外温度计测量皮瓣皮肤温度。
通过 Semmes-Weinstein 单丝试验(1.5 对 4.3 对 1.4;P < 0.05)和生物感觉计(26.8 对 31.2 对 22.3;P < 0.05),发现前胸部区域的感觉随时间而变化。术后 3 个月,前胸部区域的感觉恢复至术前水平。在任何时间点,红外温度计试验均无显著差异(36.2 对 36.2 对 36.3°C;P = 0.9927)。
尽管术后 1 个月前胸部区域的感觉发生改变,但在 BABA 后 3 个月恢复正常。这些结果表明 BABA 对前胸部区域感觉的不良影响较小。