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经口内镜下甲状腺乳头状微小癌切除术:单中心外科医生的初步经验

Transoral endoscopic thyroidectomy for papillary thyroid microcarcinoma: initial experience of a single surgeon.

作者信息

Chai Young Jun, Chung Jung Kee, Anuwong Angkoon, Dionigi Gianlorenzo, Kim Hoon Yub, Hwang Ki-Tae, Heo Seung Chul, Yi Ka Hee, Lee Kyu Eun

机构信息

Department of Surgery, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea.

Minimally Invasive and Endocrine Surgery Division, Department of Surgery, Police General Hospital, Bangkok, Thailand.

出版信息

Ann Surg Treat Res. 2017 Aug;93(2):70-75. doi: 10.4174/astr.2017.93.2.70. Epub 2017 Jul 28.

Abstract

PURPOSE

Recently, transoral endoscopic thyroidectomy (TOET) is receiving attention because it is regarded as a true minimally invasive surgery in that it does not leave scars on any part of the body and the area of flap dissection is similar to that of open surgery. In this study, we present the surgical procedures and initial outcomes of TOET in the treatment of papillary thyroid microcarcinoma (PTMC) patients.

METHODS

The medical records of patients who underwent TOET for PTMC between July 2016 and February 2017 were retrospectively reviewed. Indication of TOET was PTMC without capsular invasion or lymph node metastasis on preoperative imaging studies.

RESULTS

Ten female patients were enrolled. Seven patients underwent thyroid lobectomy and three patients underwent isthmusectomy. The mean age and tumor size was 43.3 ± 11.5 years and 0.6 ± 0.2 cm, respectively. Operation time for lobectomy and isthmusectomy was 121.1 ± 30.7 (range, 65-148) and 90.0 ± 9.2 minutes (range, 82-100 minutes), respectively. The mean number of retrieved lymph nodes was 2.7 ± 1.7. Two patients had transient vocal cord palsy, which recovered in three months. There was no case with subcutaneous emphysema, surgical site infection, postoperative bleeding, or mental nerve injury.

CONCLUSION

TOET was feasible and could be performed safely for PTMC. TOET might become a new treatment option for the patients who do not want to leave visible scars on the body.

摘要

目的

最近,经口内镜甲状腺切除术(TOET)受到关注,因为它被视为真正的微创手术,不会在身体任何部位留下疤痕,皮瓣分离面积与开放手术相似。在本研究中,我们展示了TOET治疗甲状腺微小乳头状癌(PTMC)患者的手术步骤和初步结果。

方法

回顾性分析2016年7月至2017年2月间接受TOET治疗PTMC患者的病历。TOET的适应症为术前影像学检查显示无包膜侵犯或淋巴结转移的PTMC。

结果

纳入10例女性患者。7例患者接受甲状腺叶切除术,3例患者接受峡部切除术。平均年龄和肿瘤大小分别为43.3±11.5岁和0.6±0.2cm。叶切除术和峡部切除术的手术时间分别为121.1±30.7(范围65 - 148)和90.0±9.2分钟(范围82 - 100分钟)。平均取出淋巴结数为2.7±1.7。2例患者出现短暂性声带麻痹,3个月后恢复。无皮下气肿、手术部位感染、术后出血或喉返神经损伤病例。

结论

TOET对PTMC是可行的且能安全实施。TOET可能成为不想在身体上留下可见疤痕患者的一种新的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd44/5566749/c849716bedf9/astr-93-70-g001.jpg

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