经口内镜甲状腺手术前庭入路失误的经验教训
Lessons Learned From a Faulty Transoral Endoscopic Thyroidectomy Vestibular Approach.
作者信息
Zhang Daqi, Wu Che-Wei, Inversini Davide, Kim Hoon Yub, Anuwong Angkoon, Bacuzzi Alessandro, Dionigi Gianlorenzo
机构信息
Division of Thyroid Surgery, Jilin Provincial Key Laboratory of Surgical Translational Medicine, China Japan Union Hospital of Jilin University, Changchun city, Jilin Province, China.
Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Municipal Hsiao-Kang Hospital.
出版信息
Surg Laparosc Endosc Percutan Tech. 2018 Oct;28(5):e94-e99. doi: 10.1097/SLE.0000000000000555.
BACKGROUND
Transoral endoscopic thyroidectomy via vestibular approach (TOETVA) is currently considered the most promisingly scarless approach to the thyroid and has gained more acceptance.
MATERIALS AND METHODS
We described a case of faulty TOETVA.
RESULTS
The faulty TOETVA resulted in pneumomediastinum, diffuse subcutaneous emphysema, prolonged surgery, and anesthesia.
CONCLUSIONS
The important technical considerations during TOETVA, including the use of external retraction, the identification of the subplatysmal plane of dissection, CO2 insufflation settings, the learning curve, and patient selection, were described and discussed.
背景
经口前庭入路内镜甲状腺切除术（TOETVA）目前被认为是甲状腺手术中最具前景的无瘢痕手术方式，且已获得更多认可。
材料与方法
我们描述了一例经口前庭入路内镜甲状腺切除术失败的病例。
结果
经口前庭入路内镜甲状腺切除术失败导致了纵隔气肿、弥漫性皮下气肿、手术及麻醉时间延长。
结论
描述并讨论了经口前庭入路内镜甲状腺切除术过程中的重要技术要点，包括外部牵引的使用、颈阔肌下解剖平面的识别、二氧化碳气腹设置、学习曲线及患者选择。
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