Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Minimally Invasive and Endocrine Surgery Division, Department of Surgery, Police General Hospital, Bangkok, Thailand.
Surg Endosc. 2019 Jul;33(7):2104-2113. doi: 10.1007/s00464-018-6481-9. Epub 2019 May 28.
Transoral endoscopic thyroidectomy vestibular approach is expected to be a safe alternative to open surgery for certain patients and has been used increasingly by several surgeons around the world for the past 2 years. The purpose of this paper is to review our 2-year experience and describe in detail our preoperative considerations, patient selection, operating room settings, anesthetic considerations, surgical technique, postoperative management, and outcomes.
We reviewed the medical records of 65 consecutive patients who underwent transoral endoscopic thyroidectomy between July 2016 and May 2018 in our hospital.
We have performed 65 thyroid surgeries (54 thyroid lobectomies, 1 completion thyroidectomy, and 10 total thyroidectomies) in 64 patients. Postoperative pathology revealed papillary carcinoma in 55 patients (84.6%), follicular carcinoma in two (3.1%), hyalinizing trabecular tumor in one (1.5%), and other benign tumor in seven (10.8%). All surgical margins were negative. Two (3.1%) patients developed transient vocal cord palsy but recovered within 2 months. One (1.5%) patient with vocal cord palsy had not recovered by 3 months after surgery. Five (7.7%) patients who underwent total thyroidectomy developed transient hypocalcemia but recovered within 2 months.
Although transoral thyroid surgery is a relatively recent technique requiring further validation, it affords several advantages. Transoral thyroid surgery has not yet been universally accepted, but may be the best choice for thyroid surgery in the future.
经口内镜甲状腺手术（transoral endoscopic thyroidectomy，TET）经口入路被认为是某些患者安全的替代开放手术的方法，在过去的 2 年中，全世界有几位外科医生越来越多地使用这种方法。本文旨在回顾我们的 2 年经验，并详细描述我们的术前考虑、患者选择、手术室设置、麻醉考虑、手术技术、术后管理和结果。
我们回顾了 2016 年 7 月至 2018 年 5 月期间在我院接受经口内镜甲状腺手术的 65 例连续患者的病历。
我们在 64 例患者中完成了 65 例甲状腺手术（54 例甲状腺叶切除术、1 例全甲状腺切除术和 10 例甲状腺全切除术）。术后病理显示 55 例（84.6%）为乳头状癌，2 例（3.1%）为滤泡状癌，1 例（1.5%）为透明细胞小梁肿瘤，7 例（10.8%）为其他良性肿瘤。所有手术切缘均为阴性。2 例（3.1%）患者发生暂时性声带麻痹，但在 2 个月内恢复。1 例（1.5%）声带麻痹患者在术后 3 个月仍未恢复。5 例（7.7%）行甲状腺全切除术的患者发生短暂性低钙血症，但在 2 个月内恢复。
虽然经口甲状腺手术是一种相对较新的技术，需要进一步验证，但它具有许多优点。经口甲状腺手术尚未被普遍接受，但可能是未来甲状腺手术的最佳选择。
