Takeda Saori, Enomoto Keisuke, Hiraoka Masanobu, Kumashiro Naoko, Miyamoto Mai, Hirayama Shun, Kimura Takahito, Tamagawa Shunji, Kono Masamitsu, Sugita Gen, Ohtani Makiko, Hotomi Muneki
Department of Otorhinolaryngology-Head and Neck Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan.
Surg Open Sci. 2022 Mar 30;9:19-23. doi: 10.1016/j.sopen.2022.03.007. eCollection 2022 Jul.
Despite endoscopic thyroid surgery contributing to excellent cosmetic outcomes, it requires longer surgical time than open surgery. This study evaluates the factors associated with operative time in video-assisted neck surgery.
We retrospectively reviewed patients who underwent hemithyroidectomy by video-assisted neck surgery at a single hospital between 2017 and 2021. The clinical parameters were evaluated: age, sex, body weight, body mass index, coexistence of Hashimoto thyroiditis, side of operation, surgical approach to thyroid (midline approach or lateral approach), operation time, amount of blood loss during surgery, maximum tumor diameter and tumor volume, and postoperative complications. These parameters were compared to investigate the association of operative time and surgical approach.
Seventy consecutive patients were enrolled in this study, the median age at operation was 50 years, and there were 6 (8.6%) men and 64 (91.4%) women. The median body weight and body mass index at operation were 56.6 kg and 21.5, respectively. Coexistence of Hashimoto thyroiditis was found in 17 (24.3%) patients. Significant differences were found between the groups with longer and shorter operation time than median 201 minutes in surgical approaches to the thyroid ( < .001) and the amount of bleeding during surgery ( = .039). There were no differences in other candidates between the groups. Median operation times were 242 minutes in midline approach and 131 minutes in lateral approach ( < .001).
The lateral approach of video-assisted neck surgery to the thyroid can contribute to shortened surgical time in the case of benign thyroid nodules.
尽管内镜甲状腺手术具有出色的美容效果，但与开放手术相比，其手术时间更长。本研究评估了视频辅助颈部手术中与手术时间相关的因素。
我们回顾性分析了2017年至2021年间在一家医院接受视频辅助颈部甲状腺半切术的患者。评估了以下临床参数：年龄、性别、体重、体重指数、是否合并桥本甲状腺炎、手术侧别、甲状腺手术入路（中线入路或外侧入路）、手术时间、术中失血量、肿瘤最大直径和肿瘤体积以及术后并发症。比较这些参数以研究手术时间与手术入路之间的关联。
本研究共纳入70例连续患者，手术时的中位年龄为50岁，男性6例（8.6%），女性64例（91.4%）。手术时的中位体重和体重指数分别为56.6 kg和21.5。17例（24.3%）患者合并桥本甲状腺炎。在甲状腺手术入路（<.001）和术中出血量（=.039）方面，手术时间长于和短于中位201分钟的两组之间存在显著差异。两组在其他指标上无差异。中线入路的中位手术时间为242分钟，外侧入路为131分钟（<.001）。
对于良性甲状腺结节，视频辅助颈部甲状腺手术的外侧入路可缩短手术时间。
