Department of Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Int J Surg. 2017 Jul;43:1-6. doi: 10.1016/j.ijsu.2017.05.030. Epub 2017 May 11.
Recently, we have reported single incision endoscopic thyroidectomy using an axillary approach with gas inflation (SIET) in cases with benign thyroid tumors to reduce post-operative pain and invasiveness of the conventional endoscopic thyroidectomy. The aim of this study was to present our experiences with SIET for papillary thyroid cancer (PTC).
Patients who were diagnosed with histologically papillary thyroid carcinoma (≤1 cm) with single, unilateral, and intra-thyroidal lesion and without clinical lymph node metastasis were included. We analyzed clinico-pathological characteristics, surgical outcomes, and oncologic adequacy of the SIET procedure.
Between January 2011 and July 2012, a total of 75 patients underwent hemi-thyroidectomy with ipsilateral central lymph node dissection via SIET. The mean tumor size was 0.5 cm and 4.1 ± 2.43 central lymph nodes were removed. Of the patients, 98.3% were satisfied with their surgical wound post-operatively and no critical post-operative complications occurred during the study, except for one case of post-operative bleeding. There was one case of disease recurrence, which occurred in the contra-lateral cervical lymph node region 6 months after SIET. This patient underwent completion thyroidectomy with selective neck dissection.
The SIET is a safe and acceptable procedure for PTC with a reduced dissection field, less post-operative pain, and more cosmetic satisfaction than conventional endoscopic thyroid surgery.
最近,我们报道了一种经腋入路充气式单切口内镜甲状腺切除术(SIET)用于治疗良性甲状腺肿瘤,以减轻传统内镜甲状腺手术的术后疼痛和侵袭性。本研究旨在介绍我们在甲状腺乳头状癌(PTC)患者中应用 SIET 的经验。
纳入的患者为经组织学诊断为甲状腺乳头状癌(≤1cm)、单发、单侧、甲状腺内病变且无临床淋巴结转移的患者。我们分析了 SIET 手术的临床病理特征、手术结果和肿瘤学充分性。
2011 年 1 月至 2012 年 7 月期间,共有 75 例患者接受了经 SIET 的单侧甲状腺半切除术和同侧中央淋巴结清扫术。平均肿瘤大小为 0.5cm,切除中央淋巴结 4.1±2.43 个。98.3%的患者对术后手术切口满意,除 1 例术后出血外,研究期间无其他严重术后并发症。有 1 例病例出现疾病复发,在 SIET 后 6 个月发生在对侧颈淋巴结区域。该患者接受了选择性颈淋巴结清扫术的全甲状腺切除术。
与传统内镜甲状腺手术相比,SIET 是一种安全且可接受的治疗 PTC 的方法,具有减少的手术范围、较少的术后疼痛和更高的美容满意度。