Shan Yuanzhou, Zhang Guangjun, Yu Zhenfeng, Shen Ye, Wang Shiguang, Jiang Yeping, Zhang Xueli
Department of General Surgery, Fengxian Central Hospita , Shanghai City, China.
J Laparoendosc Adv Surg Tech A. 2013 Jul;23(7):584-7. doi: 10.1089/lap.2012.0386. Epub 2013 May 7.
To investigate the feasibility and safety of transareola single-site endoscopic thyroidectomy.
Twenty-eight patients with thyroid nodules were involved in this study. An incision was cut on a single areola, and a laparoendoscope apparatus and an operating apparatus were implanted. The thyroid gland was exposed using the neck suture suspension technique, and the damaged thyroid gland was removed with an ultrasonic scalpel. The operation time, intraoperative bleeding volume, postoperative pain score, and cosmetic satisfaction score were calculated.
Unilateral subtotal thyroidectomy was performed in 12 cases, unilateral partial thyroidectomy in 14 cases, and bilateral partial thyroidectomy in 2 cases. For the former 14 cases, the operation time was 145-205 minutes, with a mean duration of 170 minutes; the operation time ranged from 125 to 150 minutes, with a mean of 135 minutes, for the latter 14 cases. The intraoperative bleeding volume was 15-40 mL, with a mean of 25 mL. The total postoperative wound drainage was 80-135 mL, with a mean of 110 mL. The drainage tube was removed 3-4 days after surgery. The visual analog scale score was 1-5 at 24 hours postoperatively, with a mean score of 3.10. Postoperative pathological examination diagnosed thyroid adenoma in 11 cases and nodular goiter in 17 cases.
Transareola single-site endoscopic thyroidectomy is feasible and safe and has the advantages of a covert incision, small subcutaneous separation area, and high cosmetic satisfaction. The operation time shortens with the increasing number of patients undergoing operations.
探讨经乳晕单孔腔镜甲状腺手术的可行性及安全性。
选取28例甲状腺结节患者纳入本研究。在单乳晕处做切口,植入腹腔镜设备及手术器械。采用颈部缝线悬吊技术暴露甲状腺,用超声刀切除病变甲状腺。计算手术时间、术中出血量、术后疼痛评分及美容满意度评分。
单侧甲状腺次全切除术12例,单侧甲状腺部分切除术14例,双侧甲状腺部分切除术2例。前14例手术时间为145 - 205分钟,平均170分钟;后14例手术时间为125 - 150分钟,平均135分钟。术中出血量为15 - 40毫升,平均25毫升。术后伤口总引流量为80 - 135毫升,平均110毫升。术后3 - 4天拔除引流管。术后24小时视觉模拟评分法评分为1 - 5分,平均3.10分。术后病理检查诊断甲状腺腺瘤11例,结节性甲状腺肿17例。
经乳晕单孔腔镜甲状腺手术可行且安全,具有切口隐蔽、皮下分离范围小、美容满意度高的优点。随着手术例数增多,手术时间缩短。