Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 33, Yingfeng Road, Guangzhou, 510289, Guangdong, China.
Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 33, Yingfeng Road, Guangzhou, 510289, Guangdong, China.
Surg Endosc. 2023 Oct;37(10):7867-7875. doi: 10.1007/s00464-023-10401-6. Epub 2023 Aug 28.
Conventional thyroidectomy leaves an eye-catching scar in the anterior neck region. Endoscopic thyroidectomy may achieve a better esthetic effect and improve quality of life postoperatively. The aim of this study was to undertake a complete review of a large cohort of the patients undergoing gasless endoscopic thyroidectomy (GET) via anterior chest approach (ACA) with a long-term follow-up period, and evaluate the results and limits of this procedure.
Between 2003 and 2022, 1413 patients undergoing GET via ACA in our department were included. The demographic, clinicopathological characteristics, oncologic and esthetic outcomes were summarized and analyzed.
The indication for surgery was papillary thyroid carcinoma in 686 (48.5%) patients and benign thyroid diseases in 727 (51.5%) patients. Among them, 802 (56.8%) patients took hemithyroidectomy, and 611 (43.2%) patients did sub-total/total thyroidectomy. Meanwhile, 598 (42.3%) ones had central neck dissection, while 88 (6.2%) lateral neck dissection. The most common complication was transient hypoparathyroidism with an incidence of 2.9%. During the follow-up period of 2 to 232 months, three patients were confirmed locoregional recurrence. Most of the patients were satisfied with the cosmetic results.
Gasless endoscopic thyroidectomy via anterior chest approach is a safe and feasible procedure, which could achieve excellent oncologic and esthetic outcomes.
传统的甲状腺切除术会在前颈部区域留下明显的疤痕。内镜甲状腺切除术可能会达到更好的美容效果，并改善术后生活质量。本研究的目的是对通过前胸入路（ACA）进行无气内镜甲状腺切除术（GET）的大量患者进行全面回顾，并评估该手术的结果和局限性。
在 2003 年至 2022 年期间，我们科室共对 1413 例行 ACA 下 GET 的患者进行了研究。总结并分析了这些患者的人口统计学、临床病理学特征、肿瘤学和美容学结果。
手术适应证为甲状腺乳头状癌 686 例（48.5%）和良性甲状腺疾病 727 例（51.5%）。其中，802 例（56.8%）患者行半甲状腺切除术，611 例（43.2%）患者行甲状腺次全/全切术。同时，598 例（42.3%）患者行中央区淋巴结清扫术，88 例（6.2%）患者行侧颈区淋巴结清扫术。最常见的并发症是暂时性甲状旁腺功能减退，发生率为 2.9%。在 2 至 232 个月的随访期间，有 3 例患者确诊局部复发。大多数患者对美容效果满意。
通过前胸入路进行无气内镜甲状腺切除术是一种安全可行的手术方法，可获得良好的肿瘤学和美容学效果。
