Prasert Wilairat
J Med Assoc Thai. 2016 Jul;99 Suppl 4:S42-7.
Endoscopic thyroidectomy has increased in popularity because of the good cosmesis. In Thailand, most endoscopic thyroidectomy surgeries are done with a gas technique, using CO2 insufflation to obtain a working space. The CO2 pressure has to be kept under control to prevent gas-related complications. In contrast, there are no such complications in video assisted neck surgery (VANS), a gasless technique. The VANS technique could be an option of endoscopic thyroidectomy in Thailand.
This study reports the outcome of the initial experience of using gasless endoscopic thyroidectomy (VANS technique) in Thailand.
From July to October 2015, five patients underwent thyroidectomy with the VANS technique at Thammasat University Hospital. Patient selection criteria consisted of non-malignant nodule diagnosed by FNA, nodule size <4 cm, no previous neck surgery and no neck irradiation.
All five patients successfully underwent endoscopic thyroid lobectomy with the VANS technique. The mean operating time was 152 minutes and mean blood loss was 34 ml. There were no serious complications, and the patients were satisfied with the cosmetic outcomes. Pathologic results were nodular goiter in four cases and adenomatous goiter with occult papillary microcarcinoma in one case (in this case, the margins were free of malignancy).
The VANS technique is feasible and safe to be used in Thailand.
由于良好的美容效果，内镜甲状腺切除术越来越受欢迎。在泰国，大多数内镜甲状腺切除手术采用气体技术，通过二氧化碳充气来获得操作空间。必须控制二氧化碳压力以预防与气体相关的并发症。相比之下，无气技术的视频辅助颈部手术（VANS）则不存在此类并发症。VANS技术可能是泰国内镜甲状腺切除术的一种选择。
本研究报告了在泰国使用无气内镜甲状腺切除术（VANS技术）的初步经验结果。
2015年7月至10月，5例患者在泰国法政大学医院接受了VANS技术的甲状腺切除术。患者选择标准包括经细针穿刺活检（FNA）诊断为非恶性结节、结节大小<4 cm、既往无颈部手术史且无颈部放疗史。
所有5例患者均成功接受了VANS技术的内镜甲状腺叶切除术。平均手术时间为152分钟，平均失血量为34毫升。无严重并发症，患者对美容效果满意。病理结果为4例结节性甲状腺肿，1例腺瘤性甲状腺肿合并隐匿性乳头状微癌（该病例切缘无恶性肿瘤）。
VANS技术在泰国使用是可行且安全的。
