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经口甲状腺切除术的系统评价

A Systemic Review of Transoral Thyroidectomy.

作者信息

Shan Liqun, Liu Jianing

机构信息

Departments of Surgery.

Thyroid Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.

出版信息

Surg Laparosc Endosc Percutan Tech. 2018 Jun;28(3):135-138. doi: 10.1097/SLE.0000000000000512.

Abstract

BACKGROUND

Transoral thyroidectomy is a kind of "natural orifice transluminal endoscopic surgery (NOTES)" which is now being performed in increasing frequency. However, the safety and feasibility have not been concluded yet.

MATERIALS AND METHODS

A systemic literature search was performed in Pubmed, Cochrane, and Embase databases to identify all studies written in English and published up to April 2017. The keywords used were "transoral endoscopic," "transoral robotic," "oral vestibular endoscopic," and "oral vestibular robotic" combined with "thyroidectomy" or "thyroid surgery."

RESULTS

Ten articles containing 211 cases matched the review criteria. The weighted average operative time was 119.9 minutes with an average intraoperative blood loss of 35.5 mL while the weighted average length of hospital stay was 4.0 days. The overall conversion rate to open surgery was 1.9%. An overall incidence rate of temporary hypoparathyroidism was 7.1%, temporary recurrent laryngeal nerve injury was 4.3%, whereas of mental nerve palsy was 4.3%.

CONCLUSIONS

According to those reviewed literatures, we can conclude that transoral thyroidectomy is safe and feasible in well-selected patients and offers good perioperative and postoperative outcomes.

摘要

背景

经口甲状腺切除术是一种“自然腔道内镜手术(NOTES)”,目前其开展频率日益增加。然而,其安全性和可行性尚未定论。

材料与方法

在Pubmed、Cochrane和Embase数据库中进行系统的文献检索,以识别截至2017年4月发表的所有英文研究。使用的关键词为“经口内镜”“经口机器人”“口腔前庭内镜”和“口腔前庭机器人”,并与“甲状腺切除术”或“甲状腺手术”组合。

结果

10篇包含211例病例的文章符合纳入标准。加权平均手术时间为119.9分钟,平均术中失血量为35.5毫升,加权平均住院时间为4.0天。开放手术的总体转换率为1.9%。暂时性甲状旁腺功能减退的总体发生率为7.1%,暂时性喉返神经损伤为4.3%,而颏神经麻痹为4.3%。

结论

根据这些综述文献,我们可以得出结论,经口甲状腺切除术在精心挑选的患者中是安全可行的,并能提供良好的围手术期和术后结果。

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