Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China.
Department of Thyroid Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Laryngoscope. 2024 Jun;134(6):2976-2984. doi: 10.1002/lary.31197. Epub 2023 Nov 21.
We developed a novel method for thyroidectomy using a single-incision oral vestibular approach. To assess its advantages and disadvantages, we compared the perioperative parameters of this approach with those of transoral three-incision thyroidectomy and trans-areolar thyroidectomy.
In a study of 136 papillary thyroid carcinoma patients (2016-2018), precise thyroidectomy and neck dissection were conducted. Among them, 52 chose single-incision oral vestibular approach, 33 chose three-incision variant, and 51 underwent trans-areolar thyroidectomy. Perioperative aspects of the transoral single-incision group were compared with those of transoral three-incision group, and transthoracic group.
In the cohort, meticulous tumor level VI lymph node dissection was performed, achieving intended resection extent with one case requiring a switch from transoral to transthoracic approach. No nerve palsy occurred in the transoral group. Thyroidectomy duration varied significantly across groups. Transoral single-incision had a shorter duration than transoral three-incision and longer than transthoracic. Minor differences were observed in blood loss and drainage. Perioperative factors like hematoma, infection, hypocalcemia, et al., remained consistent. Notably, no tumor recurrence was observed in this study.
This new transoral video-assisted neck surgery (TOVANS) method for thyroidectomy without gas insufflation approach did not increase the surgical complexity compared with the transoral vestibular three-incision thyroidectomy and the trans-areolar thyroidectomy.
3 Laryngoscope, 134:2976-2984, 2024.
我们开发了一种新的经口前庭入路甲状腺切除术，旨在评估其优缺点，将其与经口三切口甲状腺切除术和乳晕入路甲状腺切除术的围手术期参数进行比较。
在一项对 136 例甲状腺乳头状癌患者（2016-2018 年）的研究中，进行了精确的甲状腺切除术和颈部淋巴结清扫术。其中 52 例患者选择经口前庭单切口入路，33 例患者选择经口三切口改良入路，51 例患者选择乳晕入路甲状腺切除术。比较经口单切口组与经口三切口组和经胸组的围手术期情况。
在该队列中，对颈 VI 水平的淋巴结进行了精细的清扫，1 例患者需要从经口转为经胸入路以实现预期的切除范围。经口组无神经麻痹发生。甲状腺切除术时间在各组之间差异显著。经口单切口组的手术时间短于经口三切口组，长于经胸组。出血量和引流差异较小。围手术期因素如血肿、感染、低钙血症等保持一致。值得注意的是，本研究中未观察到肿瘤复发。
与经口前庭三切口甲状腺切除术和乳晕入路甲状腺切除术相比，这种新的经口视频辅助颈部手术（TOVANS）方法无需充气入路进行甲状腺切除术，并未增加手术复杂性。
3 级。喉镜，134：2976-2984，2024 年。
