分析场景引导的无气腋窝内镜甲状腺切除术中的相机辅助：手术技术的微小改进。
Analysis of scene-guided camera assistance in transaxillary gasless endoscopic thyroidectomy: a minor improvement in operative technique.
机构信息
Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
出版信息
Front Endocrinol (Lausanne). 2023 Apr 19;14:1146336. doi: 10.3389/fendo.2023.1146336. eCollection 2023.
BACKGROUND
Transaxillary gasless endoscopic thyroidectomy (TGET) is a widely performed operation, but its side view angle and instrument interference have caused concerns for most surgical groups. The aim of this study was to introduce scene-guided camera assistance (SGA) and analyze its role in facilitating TGET.
METHODS
We put forward key points for camera holders, including one pivot, two positions, and three planes, and separated TGET operations into five parts. We also established the view angle for each part of the operation for the camera holder to follow. Then, we reviewed 416 patients who underwent TGET with or without SGA and analyzed their demographic characteristics, operative outcomes, pathologic outcomes, and early complications.
RESULTS
The TGET and TGET-SGA groups were similar in terms of age, sex ratio, height, weight, tumor size, Hashimoto's thyroiditis ratio, and cN1 ratio. The operation time and postoperative hospital stay were significantly longer in the TGET group than in the TGET-SGA group (114.43 ± 17.20 minutes vs. 101.82 ± 19.39 minutes and 3.16 ± 0.77 days vs. 2.16 ± 0.55 days, respectively, ). The account of retrieved lymph nodes was less in the TGET group than in the TGET-SGA group (5.61 ± 4.27 vs. 6.57 ± 4.96, ).
CONCLUSION
SGA provided guidance for camera holders, and the data showed that it was an improvement for TGET operations.
背景
经腋窝无气腔内镜甲状腺切除术（TGET）是一种广泛开展的手术，但由于侧视角度和器械干扰问题，引起了大多数外科医生的关注。本研究旨在介绍场景引导式摄像辅助（SGA），并分析其在促进 TGET 中的作用。
方法
我们提出了摄像助手的关键点，包括一个枢轴、两个位置和三个平面，并将 TGET 手术分为五个部分。我们还为摄像助手确定了每个手术部分的观察角度。然后，我们回顾性分析了 416 例行 TGET 术和 TGET-SGA 术患者的临床资料，包括患者的人口统计学特征、手术结果、病理结果和早期并发症。
结果
TGET 组和 TGET-SGA 组在年龄、性别比、身高、体重、肿瘤大小、桥本甲状腺炎比例和 cN1 比例方面无显著差异。TGET 组的手术时间和术后住院时间明显长于 TGET-SGA 组（分别为 114.43±17.20 分钟和 101.82±19.39 分钟，3.16±0.77 天和 2.16±0.55 天）。TGET 组中取出的淋巴结数量少于 TGET-SGA 组（分别为 5.61±4.27 个和 6.57±4.96 个）。
结论
SGA 为摄像助手提供了指导，数据表明，它是 TGET 手术的一种改进。
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