Liang F Y, Lin P L, Lin X J, Han P, Chen R H, Wang J Y, Zou X, Huang X M
Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province, Guangzhou 510280, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Jun 7;58(6):596-601. doi: 10.3760/cma.j.cn115330-20221108-00672.
To explore the feasibility and safety of the gasless transoral vestibular robotic thyroidectomy using skin suspension. The clinical data of 20 patients underwent gasless transoral vestibular robotic thyroidectomy in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from February 2022 to May 2022 were retrospectively analyzed. Among them, 18 were females and 2 were males, aged (38.7±8.0) years old. The intraoperative blood loss, operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain visual analogue scale (VAS) score, postoperative swallowing function swallowing impairment score-6 (SIS-6), postoperative aesthetic VAS score, postoperative voice handicap index-10 (VHI-10) voice quality, postoperative pathology and complications were recorded. SPSS 25.0 was used for statistical analysis of the data. The operations were successfully completed without conversion to open surgery in all patients. Pathological examination showed papillary thyroid carcinoma in 18 cases, retrosternal nodular goiter in 1 case, and cystic change in goiter in 1 case. The operative time for thyroid cancer was 161.50 (152.75, 182.50) min [ (, ), the same below] and the average operative time for benign thyroid diseases was 166.50 minutes. The intraoperative blood loss 25.00 (21.25, 30.00) ml. In 18 cases of thyroid cancer, the mean diameter of the tumors was (7.22±2.02) mm, and lymph nodes (6.56±2.14) were dissected in the central region, with a lymph node metastasis rate of 61.11%. The postoperative pain VAS score was 3.00 (2.25, 4.00) points at 24 hours, the mean postoperative drainage volume was (118.35±24.32) ml, the postoperative hospital stay was 3.00 (3.00, 3.75) days, the postoperative SIS-6 score was (4.90±1.58) points at 3 months, and the postoperative VHI-10 score was 7.50 (2.00, 11.00) points at 3 months. Seven patients had mild mandibular numbness, 10 patients had mild cervical numbness, and 3 patients had temporary hypothyroidism three months after surgery and 1 patient had skin flap burn, but recovered one month after surgery. All patients were satisfied with the postoperative aesthetic effects, and the postoperative aesthetic VAS score was 10.00 (10.00, 10.00). Gasless transoral vestibular robotic thyroidectomy using skin suspension is a safe and feasible option with good postoperative aesthetic effect, which can provide a new treatment option for some selected patients with thyroid tumors.
探讨采用皮肤悬吊的免充气经口前庭机器人甲状腺切除术的可行性和安全性。回顾性分析2022年2月至2022年5月在中山大学孙逸仙纪念医院耳鼻咽喉科接受免充气经口前庭机器人甲状腺切除术的20例患者的临床资料。其中，女性18例，男性2例，年龄（38.7±8.0）岁。记录术中出血量、手术时间、术后住院时间、术后引流量、术后疼痛视觉模拟评分（VAS）、术后吞咽功能吞咽障碍评分-6（SIS-6）、术后美观VAS评分、术后嗓音障碍指数-10（VHI-10）嗓音质量、术后病理及并发症。采用SPSS 25.0对数据进行统计分析。所有患者均成功完成手术，无一例转为开放手术。病理检查显示，甲状腺乳头状癌18例，胸骨后结节性甲状腺肿1例，甲状腺肿囊性变1例。甲状腺癌手术时间为161.50（152.75，182.50）分钟[（，），下同]，良性甲状腺疾病平均手术时间为166.50分钟。术中出血量25.00（21.25，30.00）ml。18例甲状腺癌患者中，肿瘤平均直径为（7.22±2.02）mm，中央区清扫淋巴结（6.56±2.14）枚，淋巴结转移率为61.11%。术后24小时疼痛VAS评分为3.00（2.25，4.00）分，术后平均引流量为（118.35±24.32）ml，术后住院时间为3.00（3.00，3.75）天，术后3个月SIS-6评分为（4.90±1.58）分，术后3个月VHI-10评分为7.50（2.00，11.00）分。7例患者出现轻度下颌麻木，10例患者出现轻度颈部麻木，3例患者术后3个月出现暂时性甲状腺功能减退，1例患者出现皮瓣烧伤，但术后1个月恢复。所有患者对术后美观效果均满意，术后美观VAS评分为10.00（10.00，10.00）。采用皮肤悬吊的免充气经口前庭机器人甲状腺切除术是一种安全可行的选择，术后美观效果良好，可为部分选定的甲状腺肿瘤患者提供新的治疗选择。
