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[微创视频辅助甲状腺切除术。同一工作组的经验]

[Minimally Invasive Video-assisted Thyroidectomy. Experience the same working group].

作者信息

Gramática Luis, Cecenarro Rodolfo Raúl, Lorenz Evelin Sofía, Antueno Facundo Jorge

机构信息

Hospital Nacional de Clínicas - FCM - UNC..

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2017 Sep 8;74(3):251-255. doi: 10.31053/1853.0605.v74.n3.15593.

Abstract

UNLABELLED

Different thyroidectomy techniques have been developed to improve the aesthetic results, postoperative pain and to reduce hospital stay.

OBJECTIVE

To demonstrate the feasibility, safety and efficacy of minimally invasive video-assisted thyroidectomy (MIVAT). Design: Retrospective

METHODS

Ninety six patients with thyroid nodules were selected for MIVAT if they presented nodules under 35 mm in diameter, thyroid volume below 30 ml and absence of high-risk malignant tumor, lateral cervical lymphadenopathy or prior cervical surgery. Indirect laryngoscopy was performed before and after surgery to all patients. Surgery was performed through a midline incision of 1.5 cm above the sternal notch, without carbon dioxide and with magnification endoscopy. We evaluated postoperative complications, pain after surgery, the cosmetic outcome and length of stay.

RESULTS

Ninety patients underwent total thyroidectomy or near-total thyroidectomy. The average operative time was 54 ± 9 minutes. The average diameter of the nodule was 20 ± 6 mm. The average volume was 19 ± 6 ml. We documented six (6.2%) hyperparathyroidism and one recurrent laryngeal nerve palsy (0.96%), both transient and none of them permanent. The postoperative pain was minimal and all patients were discharged within 24 hours. Conclusion: In our experience the MIVAT is a safe and feasible technique for the treatment of thyroid disease, with clear advantages over conventional thyroidectomy in selected patients.

CONCLUSION

In our experience the MIVAT is a safe and feasible technique for the treatment of thyroid disease, with clear advantages over conventional thyroidectomy in selected patients.

摘要

未标注

已经开发出不同的甲状腺切除技术来改善美学效果、减轻术后疼痛并缩短住院时间。

目的

证明微创视频辅助甲状腺切除术(MIVAT)的可行性、安全性和有效性。设计:回顾性研究

方法

96例甲状腺结节患者入选MIVAT,条件为结节直径小于35mm、甲状腺体积小于30ml且无高危恶性肿瘤、侧颈淋巴结病或既往颈部手术史。所有患者术前和术后均进行间接喉镜检查。手术通过胸骨切迹上方1.5cm的中线切口进行,不使用二氧化碳,采用放大内镜。我们评估了术后并发症、术后疼痛、美容效果和住院时间。

结果

90例患者接受了全甲状腺切除术或近全甲状腺切除术。平均手术时间为54±9分钟。结节平均直径为20±6mm。平均体积为19±6ml。我们记录到6例(6.2%)甲状旁腺功能亢进和1例喉返神经麻痹(0.96%),均为暂时性,无永久性损伤。术后疼痛轻微,所有患者均在24小时内出院。结论:根据我们的经验,MIVAT是一种治疗甲状腺疾病的安全可行技术,在特定患者中比传统甲状腺切除术具有明显优势。

结论

根据我们的经验,MIVAT是一种治疗甲状腺疾病的安全可行技术,在特定患者中比传统甲状腺切除术具有明显优势。

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