经无气单侧腋窝入路内镜甲状腺切除术的手术解剖要点。
Key points of surgical anatomy for endoscopic thyroidectomy via a gasless unilateral axillary approach.
机构信息
Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.
Zhejiang Key Laboratory of Precision Medicine Research On Head & Neck Cancer, Hangzhou, 310014, China.
出版信息
Langenbecks Arch Surg. 2024 Oct 1;409(1):294. doi: 10.1007/s00423-024-03473-y.
PURPOSE
Endoscopic thyroidectomy utilizing the Gasless Unilateral Axillary Approach (GUA) offers distinct advantages including clear visibility, simple manipulation, safe oncological outcomes. This technique eliminates postoperative neck scarring, ensures concealed surgical incisions, and minimizes postoperative swallowing discomfort.
METHODS
We retrospectively reviewed 150 surgical videos to document key anatomical features and their variations during this procedure.
RESULTS
The GUA endoscopic thyroidectomy, which approaches from the contralateral side, presents significant difficulties in identifying anatomical structures, especially anatomical abnormalities in the contralateral neck, while constructing feasible operative fields. This article offers an in-depth discussion of the anatomical challenges, pitfalls, and viable strategies associated with this surgery, particularly for less experienced surgeons.
CONCLUSIONS
Given the intricate interplay of muscular, vascular, and neural anatomical structures, novices in surgery must be well-acquainted with the underlying anatomy to minimize potential complications.
目的
经无气单侧腋窝入路（GUA）的内镜甲状腺切除术具有明显优势，包括清晰的可视性、简单的操作、安全的肿瘤学结果。该技术消除了术后颈部疤痕，确保了隐蔽的手术切口，并最大限度地减少了术后吞咽不适。
方法
我们回顾性地分析了 150 个手术视频，以记录该手术过程中的关键解剖结构及其变化。
结果
从对侧入路的 GUA 内镜甲状腺切除术在识别解剖结构方面存在显著困难，尤其是在对侧颈部的解剖异常情况下，构建可行的手术区域更为困难。本文深入讨论了与该手术相关的解剖挑战、陷阱和可行策略，特别是对于经验较少的外科医生。
结论
鉴于肌肉、血管和神经解剖结构的复杂相互作用，手术新手必须熟悉潜在的解剖结构，以最大限度地减少潜在的并发症。
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