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甲状腺和甲状旁腺手术中微创切口的拉伸。

Stretch of the minimally invasive incision during thyroid and parathyroid surgery.

作者信息

Chen Nan, Stephenson Lauren A, Jorgensen Jeffrey B, Zitsch Robert P

机构信息

University of Missouri School of Medicine, Columbia, Missouri, USA.

Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA.

出版信息

Otolaryngol Head Neck Surg. 2014 Oct;151(4):582-5. doi: 10.1177/0194599814544453. Epub 2014 Jul 22.

Abstract

OBJECTIVE

Identify and quantify changes in length of the skin incision following minimally invasive thyroid and parathyroid surgery and determine whether these changes persist postoperatively.

STUDY DESIGN

Cohort study.

SETTING

Tertiary care teaching hospital.

SUBJECTS AND METHODS

Between July 2012 and June 2013, a prospective, nonrandomized study was performed on 44 consecutive patients undergoing open cervical minimally invasive thyroidectomy (incision approximately 6 cm or less) or minimally invasive parathyroidectomy (incision approximately 3 cm or less). Incision length was measured following initial incision, immediately after wound closure, and on postoperative follow-up at 2-week and 14-week visits.

RESULTS

Thirty-one patients underwent minimally invasive thyroidectomy or parathyroidectomy with initial incision lengths ranging from 20 mm to 60 mm. Seven patients (21%) underwent total thyroidectomy with a mean length of 45 ± 8 mm, 15 patients (44%) underwent unilateral thyroid lobectomy with a mean length of 37 ± 5 mm, and 9 patients (26%) underwent parathyroidectomy with a mean length of 28 ± 2 mm. On average, the skin incision lengthened by 3.0 ± 0.9 mm during surgery representing an intraoperative stretch of 8.0% (P < .0001). Incision lengths decreased by an average of 0.3 mm at 2-week postoperative follow-up (ns) and 6.3 mm at 14-week postoperative follow-up (P < .0001).

CONCLUSION

Significant intraoperative incision stretch is likely to occur during minimally invasive thyroid and parathyroid surgery. Postoperative follow-up data suggest that the increase in incision length is not permanent and resolves upon postoperative follow-up.

摘要

目的

识别并量化微创甲状腺和甲状旁腺手术后皮肤切口长度的变化,并确定这些变化在术后是否持续存在。

研究设计

队列研究。

研究地点

三级护理教学医院。

研究对象与方法

在2012年7月至2013年6月期间,对44例连续接受开放性颈部微创甲状腺切除术(切口约6厘米或更短)或微创甲状旁腺切除术(切口约3厘米或更短)的患者进行了一项前瞻性、非随机研究。在初始切口后、伤口闭合后立即以及术后2周和14周随访时测量切口长度。

结果

31例患者接受了微创甲状腺切除术或甲状旁腺切除术,初始切口长度在20毫米至60毫米之间。7例患者(21%)接受了全甲状腺切除术,平均长度为45±8毫米;15例患者(44%)接受了单侧甲状腺叶切除术,平均长度为37±5毫米;9例患者(26%)接受了甲状旁腺切除术,平均长度为28±2毫米。手术过程中,皮肤切口平均延长了3.0±0.9毫米,术中拉伸率为8.0%(P<.0001)。术后2周随访时切口长度平均减少了0.3毫米(无统计学意义),术后14周随访时减少了6.3毫米(P<.0001)。

结论

微创甲状腺和甲状旁腺手术期间可能会出现显著的术中切口拉伸。术后随访数据表明,切口长度的增加并非永久性的,术后随访时会恢复。

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