Jung Jae Cheol, Chantladze Giorgi, Kharebadze Vladimer, Ahn Jong-Hyuk, Kim Jae Hwan, Yi Jin Wook, Sikharulidze Edisher
Department of Surgery, Inha University Hospital, Inha University College of Medicine, Incheon, Korea.
Department of Surgery, Aversi Clinic, Tbilisi, Georgia.
J Minim Invasive Surg. 2020 Sep 15;23(3):126-133. doi: 10.7602/jmis.2020.23.3.126.
Remote access thyroid surgery using a bilateral axillary breast approach (BABA) or a transoral endoscopic thyroidectomy vestibular approach (TOETVA) are increasingly performed worldwide. In the Caucasus, these methods were first applied in the Republic of Georgia. This study compares these two methods of endoscopic thyroid surgery performed on patients in a tertiary hospital in Tbilisi, Georgia.
Between December 2015 and January 2018, 41 patients underwent endoscopic thyroid surgery at the Aversi Clinic, including 32 who underwent BABA endoscopic thyroidectomy for benign nodules and nine who underwent TOETVA for thyroid cancers. Patients' medical records were retrospectively reviewed.
Tumors were significantly larger (2.38±0.38 cm versus 1.70±0.31 cm, value <0.001), operation time was significantly longer (177.66±21.02 min versus 116.66±5.59 min, value <0.001), and blood loss was significantly greater (149.07±28.10 ml versus 102.22±8.33 ml, value <0.001) in patients who underwent BABA than TOETVA. There were no significant differences in postoperative complications between the two groups.
Remote access thyroid surgery, either BABA or TOETVA, was successfully started, without harmful complications, at the Aversi Clinic in Tbilisi, Georgia. BABA is suitable for large sized benign nodules and TOETVA for thyroid cancers with central lymph node dissection.
使用双侧腋窝乳房入路(BABA)或经口内镜甲状腺切除术前庭入路(TOETVA)进行的远程甲状腺手术在全球范围内越来越普遍。在高加索地区,这些方法首先在格鲁吉亚共和国应用。本研究比较了在格鲁吉亚第比利斯一家三级医院对患者进行的这两种内镜甲状腺手术方法。
2015年12月至2018年1月期间,41例患者在阿韦尔西诊所接受了内镜甲状腺手术,其中32例因良性结节接受了BABA内镜甲状腺切除术,9例因甲状腺癌接受了TOETVA手术。对患者的病历进行了回顾性分析。
接受BABA手术的患者肿瘤明显更大(2.38±0.38 cm对1.70±0.31 cm,P值<0.001),手术时间明显更长(177.66±21.02分钟对116.66±5.59分钟,P值<0.001),失血量明显更多(149.07±28.10 ml对102.22±8.33 ml,P值<0.001)。两组术后并发症无显著差异。
在格鲁吉亚第比利斯的阿韦尔西诊所成功开展了BABA或TOETVA远程甲状腺手术,且无有害并发症。BABA适用于大型良性结节,TOETVA适用于需要进行中央淋巴结清扫的甲状腺癌。