Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Eur Arch Otorhinolaryngol. 2020 Jul;277(7):2049-2054. doi: 10.1007/s00405-020-05908-w. Epub 2020 Mar 13.
The objective of this study is to compare the clinical outcomes between gas insufflation and gasless techniques used in transaxillary endoscopic thyroid lobectomy.
Data of patients who underwent transaxillary endoscopic thyroid lobectomy from June 2011 to August 2019 were reviewed. All surgeries were performed by one experienced surgeon. The patients were divided into two groups according to surgical technique as gas insufflation or gasless technique. The clinical outcomes such as complications, postoperative pain score assessed using VAS, length of hospital stay, and presence of iatrogenic ectopic thyroid tissue were compared between the two groups.
During the study period, a total of 60 patients underwent transaxillary endoscopic thyroid lobectomy: 38 patients via gas insufflation and 22 using the gasless technique. The basic characteristic features of the patients and their diseases were not significantly different between the two groups. Gas insufflation yielded significantly better surgical outcomes than the gasless technique: shorter operative time (209.3 ± 63.1 min. vs. 267.6 ± 66.0 min.; P = 0.001), less estimated blood loss [10.0 (5.0, 20.0) mL vs. 30.0 (16.2, 50.0) mL; P < 0.001], less drainage content [10.0 (0.0, 70.0) mL vs. 81.5 (74.2, 104.5) mL; P < 0.001], and shorter hospital stay [1.5 (1.1, 2.0) days vs. 1.8 (1.5, 2.5) days; P = 0.032]. Regarding postoperative pain, there was no statistically significant difference in visual analog scales (VAS) at 24 and 48 h. Finally, no evidence of iatrogenic ectopic thyroid tissue was found in both groups.
Compared to the gasless technique, the gas insufflation technique provided shorter operative time, less estimated blood loss, less drainage content, and shorter hospital stay. Moreover, there were comparable outcomes regarding postoperative pain, complications and iatrogenic ectopic thyroid tissue.
本研究旨在比较经腋窝内镜甲状腺叶切除术中使用充气与非充气技术的临床结果。
回顾 2011 年 6 月至 2019 年 8 月期间行经腋窝内镜甲状腺叶切除术的患者资料。所有手术均由一位经验丰富的外科医生完成。根据手术技术将患者分为充气组和非充气组。比较两组患者的并发症、术后视觉模拟评分（VAS）评估的疼痛评分、住院时间和医源性异位甲状腺组织的存在情况。
研究期间，共有 60 例患者行经腋窝内镜甲状腺叶切除术：38 例行充气术，22 例行非充气术。两组患者的基本特征和疾病无显著差异。充气组的手术结果明显优于非充气组：手术时间更短（209.3±63.1 min 比 267.6±66.0 min；P=0.001）、估计失血量更少[10.0（5.0，20.0）mL 比 30.0（16.2，50.0）mL；P<0.001]、引流量更少[10.0（0.0，70.0）mL 比 81.5（74.2，104.5）mL；P<0.001]、住院时间更短[1.5（1.1，2.0）天比 1.8（1.5，2.5）天；P=0.032]。术后 24 和 48 h VAS 评分无统计学差异。两组均未发现医源性异位甲状腺组织。
与非充气技术相比，充气技术可缩短手术时间、减少估计失血量、减少引流量和缩短住院时间。此外，两组在术后疼痛、并发症和医源性异位甲状腺组织方面的结果相当。
