Yi J W, Kim S-J, Lee K E
Department of Surgery, Inha University Hospital, Incheon, Republic of Korea; Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
Br J Oral Maxillofac Surg. 2020 Apr;58(3):334-340. doi: 10.1016/j.bjoms.2020.01.004. Epub 2020 Jan 22.
Transoral endoscopic thyroid surgery (TOET) is a new, minimally-invasive approach that does not result in a scar in the anterior neck. To prevent infection of the surgical site from oral cavity flora into the thyroidectomy area, postoperative antibiotics are generally given orally for 3-7 days. However, there is no clinical evidence to support this approach. This study was an open-label, randomised, controlled trial to evaluate the clinical usefulness of postoperative antibiotics given orally to patients having TOET. Patients were randomly assigned to receive amoxicillin-clavulanate 625mg orally three times a day for a week after operation (treated group) or no antibiotics (untreated group). Fifty patients - 25 treated and 25 untreated - were enrolled. Maximum body temperature, pulse rate, white blood cell count, and C-reactive protein concentrations did not differ between the two groups. Evaluation of the surgical site showed no significant differences between them. Seven patients in the treated group developed nausea, vomiting, and diarrhoea compared with none in the untreated group. The results suggest that postoperative oral antibiotics are not essential after TOET. Large-scale prospective series are required to confirm this finding.
经口内镜甲状腺手术（TOET）是一种新型的微创方法，不会在前颈部留下疤痕。为防止口腔菌群感染手术部位并扩散至甲状腺切除区域，术后通常口服抗生素3 - 7天。然而，尚无临床证据支持这种做法。本研究是一项开放标签、随机对照试验，旨在评估经口内镜甲状腺手术患者术后口服抗生素的临床效用。患者被随机分为两组，术后一组接受阿莫西林克拉维酸625mg，每日口服三次，持续一周（治疗组），另一组不使用抗生素（未治疗组）。共纳入50例患者，其中治疗组和未治疗组各25例。两组患者的最高体温、脉搏率、白细胞计数及C反应蛋白浓度无差异。手术部位评估显示两组之间无显著差异。治疗组有7例患者出现恶心、呕吐和腹泻，而未治疗组无此情况。结果表明，经口内镜甲状腺手术后口服抗生素并非必要。需要大规模前瞻性研究系列来证实这一发现。
