Liang F Y, Han P, Cai Q, Chen R H, Yu S T, Luo M R, Huang X M
Department of Otolaryngology, Sun Yat-sen Memorial Hospital,Sun Yat-sen University, Guangzhou, 510120, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Jul;32(14):1051-1055. doi: 10.13201/j.issn.1001-1781.2018.14.003.
To evaluate the feasibility, effectiveness and safety of robot-assisted transaxillary thyroidectomy (RATT). The clinical data of 66 patients undergoing RATT from November 2016 to May 2018 were prospectively collected and analyzed. The average age was (38.61±11.72) years, 57 cases were female and 9 cases were male. Preoperative fine needle aspiration biopsy revealed papillary thyroid carcinoma in 58 cases and follicular thyroid tumor in 8 cases.All the patients successfully completed RATT, and there was no open operation, in which 54 cases of ipsilateral lobetomy and isthmus resection and ipsilateral central lymph node dissection, 8 cases with ipsilateral lobectomy and contralateral near-total lobectomy, and total thyroidectomy with ipsilateral central lymph node dissection and selective neck dissection combined with retroauricular approach in 4 cases. The mean operative time was (124.30±23.41) min, and the average bleeding volume was (17.73±8.28) ml. The mean diameter of thyroid papillary carcinoma was (0.71±6.22) cm, and the postoperative drainage volume was (67.57±25.11) ml. The average postoperative hospitalization time was (3.24±0.81) days. 3 cases (4.5%) had temporary laryngeal nerve palsy after operation, and 1 case (1.5%) had temporary hypocalcemia after operation, all recovered after one month. No postoperative bleeding, subcutaneous emphysema, drinking water cough and permanent hypocalcemia were observed. The average numbers of lymph node dissection in PTC patients were (6.26±4.76), of which 21 cases (36.2%) had lymph node metastasis, postoperative stage T1 54 cases, T2 4 cases, N1a 17 cases, N1b 4 cases. The follow-up time were 1-18 months. The postoperative cosmetic VAS score in January was (9.66±0.54). Ultrasound showed no residual glands in the affected thyroid gland, and there was no recurrence in the local and regional regions.RATT is safe and feasible with good aesthetic effect and can be used as an option for the treatment of thyroid diseases..
评估机器人辅助经腋窝甲状腺切除术（RATT）的可行性、有效性和安全性。前瞻性收集并分析了2016年11月至2018年5月期间66例行RATT患者的临床资料。平均年龄为（38.61±11.72）岁，女性57例，男性9例。术前细针穿刺活检显示58例为甲状腺乳头状癌，8例为滤泡性甲状腺肿瘤。所有患者均成功完成RATT，无开放手术，其中54例行同侧叶切除加峡部切除及同侧中央区淋巴结清扫，8例行同侧叶切除加对侧近全叶切除，4例行全甲状腺切除加同侧中央区淋巴结清扫及选择性颈清扫并联合耳后入路。平均手术时间为（124.30±23.41）分钟，平均出血量为（17.73±8.28）毫升。甲状腺乳头状癌平均直径为（0.71±6.22）厘米，术后引流量为（67.57±25.11）毫升。平均术后住院时间为（3.24±0.81）天。3例（4.5%）术后出现暂时性喉返神经麻痹，1例（1.5%）术后出现暂时性低钙血症，均在1个月后恢复。未观察到术后出血、皮下气肿、饮水呛咳及永久性低钙血症。PTC患者平均清扫淋巴结数为（6.26±4.76）枚，其中21例（36.2%）有淋巴结转移，术后分期T1 54例，T2 4例，N1a 17例，N1b 4例。随访时间为1 - 18个月。术后1个月美容VAS评分为（9.66±0.54）。超声显示患侧甲状腺无残余腺体，局部及区域无复发。RATT安全可行，美容效果良好，可作为甲状腺疾病治疗的一种选择。
