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机器人甲状腺切除术。法国内分泌外科学会(AFCE)联合法国内分泌学会(SFE)及法国核医学学会(SFMN)的建议

Robotic thyroidectomy. Recommendations of the AFCE (Association francophone de chirurgie endocrinienne) with the SFE (Société française d'endocrinologie) and the SFMN (Société française de médecine nucléaire).

作者信息

Marciniak Camille, Bihain Florence, Caiazzo Robert, Brunaud Laurent

机构信息

Lille University, CHU Lille, General and Endocrine Surgery Department, Lille, France.

University of Lorraine, CHRU Nancy (Brabois), Department of Visceral, Metabolic and Cancer Surgery (CVMC), Nancy, France.

出版信息

J Visc Surg. 2023 Jun;160(3S):S127-S129. doi: 10.1016/j.jviscsurg.2023.04.006. Epub 2023 May 5.

Abstract

Transaxillary robotic thyroidectomy is hardly the approach of reference. It is occasionally proposed for carefully selected patients with a small-sized (2cm maximum), exclusively cervical unilateral nodule without lymph node involvement, in a small thyroid lobe (6cm maximum) in a thin individual wishing to avoid a cervical scar. Potential candidates must be informed on the risks specific to this technique and about the scarceness of evidence of its equivalence to cervicotomy in terms of quality of life and patient satisfaction. Shall be excluded from robotic surgery: malignant nodules (or nodules suspected of malignancy>2cm), cancers with microscopic nodal metastases, plunging goiter, patients with previous cervical surgery or overactive thyroid. Robotic thyroidectomy must be performed in centers with expertise in both thyroid surgery and robotic surgery.

摘要

经腋窝机器人甲状腺切除术很难成为首选术式。对于精心挑选的患者,即身材消瘦、甲状腺叶较小(最大6cm)、仅有颈部单侧小结节(最大2cm)且无淋巴结受累、希望避免颈部瘢痕的患者,偶尔会采用该术式。必须告知潜在的候选患者该技术特有的风险,以及在生活质量和患者满意度方面,其与颈部切开术等效性的证据不足。以下患者应排除在机器人手术之外:恶性结节(或怀疑为恶性且>2cm的结节)、有微小淋巴结转移的癌症、坠入性甲状腺肿、曾接受过颈部手术的患者或甲状腺功能亢进患者。机器人甲状腺切除术必须在具备甲状腺手术和机器人手术专业知识的中心进行。

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