Choi Jung Bum, Lee Byoung Chul, Park Young Mok, Jung Hyuk Jae, Kim Dong-Il
Department of Surgery, Pusan National University Hospital, Republic of Korea.
Department of Surgery, Pusan National University Yangsan Hospital, Republic of Korea.
Int J Surg Case Rep. 2020;75:143-146. doi: 10.1016/j.ijscr.2020.09.047. Epub 2020 Sep 10.
Minimally invasive thyroidectomy (MIT) is technically less damaging tissue and is better cosmetic results with small neck scar, decreasing postoperative pain and neck discomfort. We present the experience of MIT without remote access with case of grossly extra-thyroidal extension positive papillary thyroid carcinoma.
A 44-year-old, female presented 1.6 cm irregular hypoechoic nodule at upper pole in Right thyroid gland and diagnosed to papillary thyroid carcinoma. The tumor was suspicious to have extra-thyroidal extension. We performed MIT without remote access for this patient with 2 cm cervical incision. Postoperative course was uneventful and patient was discharged on the 3th postoperative day. At present, she is taking 100mcg levothyroxine and is free of disease 3 years post-surgery.
If experienced surgeons can get sufficient resection margin and control bleeding of superior thyroid artery, MIT without remote access can be feasible method for thyroid carcinoma with gross extra-thyroidal extension, especially, upper pole carcinoma.
微创甲状腺切除术（MIT）在技术上对组织的损伤较小，颈部疤痕小，美容效果更好，可减轻术后疼痛和颈部不适。我们介绍了在没有远程入路的情况下进行MIT治疗甲状腺乳头状癌伴甲状腺外明显侵犯的病例经验。
一名44岁女性，右侧甲状腺上极有一个1.6厘米不规则低回声结节，诊断为甲状腺乳头状癌。肿瘤疑似有甲状腺外侵犯。我们为该患者进行了无远程入路的MIT，颈部切口2厘米。术后过程顺利，患者术后第3天出院。目前，她正在服用100微克左甲状腺素，术后3年无疾病。
如果经验丰富的外科医生能够获得足够的切除边缘并控制甲状腺上动脉出血，那么对于甲状腺外明显侵犯的甲状腺癌，尤其是上极癌，无远程入路的MIT可能是一种可行的方法。
