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经口内镜甲状腺手术前庭入路(TOETVA):我们在土耳其的手术结果。

Transoral endoscopic thyroidectomy vestibular approach (TOETVA): Our outcomes from Turkey.

作者信息

Dinç Bülent, İlker Turan Mehmet, Rıza Gündüz Umut, Haluk Belen Nurhan

机构信息

Clinic of General Surgery, Health Sciences University Antalya Training and Research Hospital, Antalya, Turkey.

Clinic of General Surgery, Kepez State Hospital, Antalya, Turkey.

出版信息

Turk J Surg. 2020 Dec 29;36(4):340-346. doi: 10.47717/turkjsurg.2020.4765. eCollection 2020 Dec.

Abstract

OBJECTIVES

The Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) was described in 2016 and had its case series published. This study aimed to present the largest TOETVA case series performed in Turkey.

MATERIAL AND METHODS

Data from 52 patients who underwent TOETVA procedure between February 2018 and October 2019 were analyzed retrospectively. Demographic data, duration of operation, blood loss, rate of conversion to open surgery, radiological findings, pathological outcomes, and complications were analyzed.

RESULTS

All patients were female. Mean duration of the operation was 192 ± 45 minutes, mean blood loss was 39 ± 47 mL, and the ratio of surgical site infection was 6% (3/50). In two (4%) patients, TOETVA was converted to open surgery. Temporary and permanent recurrent laryngeal nerve (RLN) paralysis was observed in 2 (4%) and 0 patients, respectively. Temporary and permanent hypoparathyroidism was observed in 10 (20%) and 0 patients, respectively.

CONCLUSION

TOETVA procedure is the most recently defined NOTES technique for endocrine surgery. In experienced healthcare centers, TOETVA can achieve outcomes similar and even better than the ones obtained with open surgery. The complication rates, durations of operation, surgical site infection, and blood loss parameters that we observed in our experience are similar to the ones reported in the literature.

摘要

目的

经口内镜甲状腺切除术前庭入路(TOETVA)于2016年被描述并发表了其病例系列。本研究旨在展示在土耳其进行的最大规模的TOETVA病例系列。

材料与方法

回顾性分析了2018年2月至2019年10月期间接受TOETVA手术的52例患者的数据。分析了人口统计学数据、手术时长、失血量、转为开放手术的比例、影像学检查结果、病理结果及并发症情况。

结果

所有患者均为女性。平均手术时长为192±45分钟,平均失血量为39±47毫升,手术部位感染率为6%(3/50)。2例(4%)患者由TOETVA转为开放手术。分别有2例(4%)和0例患者出现暂时性和永久性喉返神经(RLN)麻痹。分别有10例(20%)和0例患者出现暂时性和永久性甲状旁腺功能减退。

结论

TOETVA手术是内分泌外科领域最新定义的NOTES技术。在经验丰富的医疗中心,TOETVA能够取得与开放手术相似甚至更好的效果。我们在实践中观察到的并发症发生率、手术时长、手术部位感染及失血量参数与文献报道相似。

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Transoral endoscopic thyroidectomy: preliminary experience in Italy.经口内镜甲状腺切除术:意大利的初步经验。
Updates Surg. 2017 Jun;69(2):225-234. doi: 10.1007/s13304-017-0436-x. Epub 2017 Apr 12.

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