Wang Huiling, Liu Rui, Zhang Chaojie, Fang Qian, Zeng Zheng, Wang Wanlin, You Shuo, Fang Meng, Dingtian Jinhao
Department of Breast and Thyroid Surgery, Hunan Provincial People's Hospital/The First Affiliated Hospital of Hunan Normal University, Changsha, China.
Front Surg. 2023 Feb 23;10:1121292. doi: 10.3389/fsurg.2023.1121292. eCollection 2023.
Gasless unilateral trans-axillary approach (GUA) thyroidectomy has witnessed rapid development in technologies and applications. However, the existence of surgical retractors and limited space would increase the difficulty of guaranteeing the visual field and disturb safe surgical manipulation. We aimed to develop a novel zero-line method for incision design to access optimal surgical manipulation and outcomes.
A total of 217 patients with thyroid cancer who underwent GUA were enrolled in the study. Patients were randomly classified into two groups (classical incision and zero-line incision), and their operative data were collected and reviewed.
216 enrolled patients underwent and completed GUA; among them, 111 patients were classified into the classical group, and 105 patients were classified into the zero-line group, respectively. Demographic data, including age, gender, and the primary tumor side, were similar between the two groups. The duration of surgery in the classical group was longer (2.66 ± 0.68 h) than in the zero-line group (1.40 ± 0.47 h) ( < 0.001). The counts of central compartment lymph node dissection were higher in the zero-line group (5.03 ± 3.02 nodes) than that in the classical group (3.05 ± 2.68 nodes) ( < 0.001). The score of postoperative neck pain was lower in the zero-line group (1.0 ± 0.36) than that in the classical group (3.3 ± 0.54) ( < 0.05). The difference in cosmetic achievement was not statistically significant ( > 0.05).
The "zero-line" method for GUA surgery incision design was simple but effective for GUA surgery manipulation and worth promoting.
免气腹单侧经腋窝入路（GUA）甲状腺切除术在技术和应用方面发展迅速。然而，手术牵开器的存在以及空间有限会增加保证视野的难度，并干扰安全的手术操作。我们旨在开发一种新的切口设计零线方法，以实现最佳的手术操作和效果。
共有217例行GUA的甲状腺癌患者纳入本研究。患者被随机分为两组（传统切口组和零线切口组），收集并回顾他们的手术数据。
216例纳入患者接受并完成了GUA；其中，111例患者被分为传统组，105例患者被分为零线组。两组的人口统计学数据，包括年龄、性别和原发肿瘤侧，相似。传统组的手术时间（2.66±0.68小时）比零线组（1.40±0.47小时）长（<0.001）。零线组的中央区淋巴结清扫数量（5.03±3.02枚）高于传统组（3.05±2.68枚）（<0.001）。零线组的术后颈部疼痛评分（1.0±0.36）低于传统组（3.3±0.54）（<0.05）。美容效果的差异无统计学意义（>0.05）。
GUA手术切口设计采用的“零线”方法对GUA手术操作简单但有效，值得推广。
