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面颈部提升甲状腺手术:适应证、手术和功能结果的系统评价。

Facelift thyroid surgery: a systematic review of indications, surgical and functional outcomes.

机构信息

Robotic Surgery Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France.

Department of Otolaryngology - Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.

出版信息

J Otolaryngol Head Neck Surg. 2023 Apr 10;52(1):25. doi: 10.1186/s40463-023-00624-x.

Abstract

OBJECTIVE

To investigate indications, surgical and functional outcomes of robotic or endoscopic facelift thyroid surgery (FTS) and whether FTS reported comparable outcomes of other surgical approaches.

DATA SOURCES

PubMed, Cochrane Library, and Scopus.

REVIEW METHODS

A literature search was conducted about indications, clinical and surgical outcomes of patients who underwent FTS using PICOTS and PRISMA Statements. Outcomes reviewed included age; gender; indications; pathology; functional evaluations; surgical outcomes and complications.

RESULTS

Fifteen papers met our inclusion criteria, accounting for 394 patients. Endoscopic or robotic FTS was carried out for benign and malignant thyroid lesions, with or without central neck dissection. Nodule size and thyroid lobe volume did not exceed 6, 10 cm, respectively. FTS reported comparable outcome with transaxillary or oral approaches about operative time, complication rates or drainage features. The mean operative time ranged from 88 to 220 min, depending on the type of surgery (endoscopic vs robotic hemi- or total thyroidectomy). Conversion to open surgery was rare, occurring in 0-6.3% of cases. The most common complications were earlobe hypoesthesia, hematoma, seroma, transient hypocalcemia and transient recurrent nerve palsy. There was an important disparity between studies about the inclusion/exclusion criteria, surgical and functional outcomes.

CONCLUSION

FTS is a safe and effective approach for thyroid benign and malignant lesions. FTS reports similar complications to conventional thyroidectomy and excellent cosmetic satisfaction.

摘要

目的

探讨机器人或内镜甲状腺面颈部提升术(FTS)的适应证、手术和功能结果,以及 FTS 是否与其他手术方法具有可比的效果。

资料来源

PubMed、Cochrane 图书馆和 Scopus。

检索方法

使用 PICOTS 和 PRISMA 声明对接受 FTS 的患者的适应证、临床和手术结果进行文献检索。审查的结果包括年龄、性别、适应证、病理、功能评估、手术结果和并发症。

结果

15 篇论文符合我们的纳入标准,共 394 例患者。内镜或机器人 FTS 用于治疗良性和恶性甲状腺病变,包括或不包括中央颈部清扫术。结节大小和甲状腺叶体积分别不超过 6 和 10 cm。FTS 与经腋窝或经口入路的手术相比,在手术时间、并发症发生率或引流特征方面具有可比性。手术时间的平均值为 88 至 220 分钟,具体取决于手术类型(内镜与机器人半或全甲状腺切除术)。转为开放性手术的情况很少见,占 0-6.3%。最常见的并发症是耳垂感觉减退、血肿、血清肿、短暂性低钙血症和暂时性喉返神经麻痹。关于纳入/排除标准、手术和功能结果,研究之间存在很大差异。

结论

FTS 是治疗甲状腺良性和恶性病变的安全有效的方法。FTS 报告的并发症与传统甲状腺切除术相似,美容满意度也很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6491/10088190/8de8bfb23bb6/40463_2023_624_Fig1_HTML.jpg

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