Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
Surg Endosc. 2017 Oct;31(10):4194-4200. doi: 10.1007/s00464-017-5477-1. Epub 2017 Mar 9.
The objective of the study was to evaluate the safety and effectiveness of three-dimensional (3D) endoscopy for thyroidectomy and compare it to two-dimensional (2D) endoscopy. The major limitations of conventional endoscopy include its lack of depth perception and tactile feedback. The 3D endoscopy technique, which involves 3D imaging, is widely used. However, few reports have described the use of 3D endoscopic systems in thyroid surgery.
In this single-institutional study, 103 consecutive patients who underwent endoscopic thyroidectomy between July 2013 and April 2014 were enrolled. Of these, 32 patients chose 3D endoscopy, and 71 patients chose 2D endoscopy and were used as a control group. All patients were stratified by type of operation.
All 103 patients underwent a successful endoscopic-assisted thyroidectomy with no conversion to open surgery. There were no differences in operation time, intraoperative bleeding, postoperative drainage, the number of lymph nodes (LNs) dissected, major complications, and hospital stays. During a median follow-up of 28.0 months, no patients experienced a recurrence of thyroid cancer.
Our preliminary report demonstrates that 3D endoscopy achieved the same level of safety and effectiveness as 2D endoscopy in endoscopic-assisted thyroidectomies. Additionally, 3D endoscopy provided good depth perception and allowed the surgeon to easily recognize critical anatomical landmarks. Further large-scale studies, preferably prospective randomized control trials, are required to confirm this finding.
本研究旨在评估三维（3D）内镜甲状腺切除术的安全性和有效性，并将其与二维（2D）内镜进行比较。传统内镜的主要局限性包括缺乏深度感知和触觉反馈。3D 内镜技术涉及 3D 成像，应用广泛。然而，鲜有报道描述 3D 内镜系统在甲状腺手术中的应用。
本单中心研究纳入了 2013 年 7 月至 2014 年 4 月期间接受内镜甲状腺切除术的 103 例连续患者。其中 32 例患者选择 3D 内镜，71 例患者选择 2D 内镜作为对照组。所有患者均按手术类型分层。
103 例患者均成功完成内镜辅助甲状腺切除术，无一例转为开放手术。手术时间、术中出血量、术后引流、淋巴结清扫数量、主要并发症和住院时间均无差异。中位随访 28.0 个月期间，无患者发生甲状腺癌复发。
我们的初步报告表明，3D 内镜在内镜辅助甲状腺切除术中达到了与 2D 内镜相同的安全性和有效性。此外，3D 内镜提供了良好的深度感知，使外科医生能够轻松识别关键的解剖标志。需要进一步开展大规模研究，最好是前瞻性随机对照试验，以证实这一发现。
