Jiang Jinxi, He Gaofei, Chu Junjie, Li Jianbo, Lu Xiaoxiao, Jiang Xianfeng, Gao Li, Zhang Deguang
Department of Head and Neck Surgery, Medical School, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, People's Republic of China.
Updates Surg. 2025 Jan;77(1):175-182. doi: 10.1007/s13304-024-01948-7. Epub 2024 Nov 27.
The main purpose of the reported endoscopic thyroidectomy with the several incisions on the chest wall or other approaches was to meet the cosmetic demands of patients, but they had inherent technical disadvantages. To solve these problems, we developed a single-incision gasless trans-subclavian approach endoscopic thyroidectomy and evaluated its feasibility. We reviewed clinical data from 243 consecutive patients who underwent gasless trans-subclavian approach endoscopic thyroidectomy with a single incision at our centre from January 2021 to March 2022. Patients' basic information, the extent of surgery, the duration of surgery, the number of lymph node dissection, postoperative hospital stay, complications, and follow-up outcomes were collected and analysed. No cases converted to open surgery. The mean time for lobectomy + central neck dissection was 84.9 ± 29.9 min and 95.0 ± 24.3 min for lobectomy. The mean number of lymph node dissection in the central compartment was 5.6 ± 3.9, with a mean number of metastatic lymph nodes of 0.8 ± 1.6. Temporary recurrent laryngeal nerve (RLN) injury occurred in eigth patients, and minor lymphatic fistula occurred in one patient. During at least 6 months of follow-up, one patient was found to have a recurrence of lateral neck lymph nodes by ultrasound 6 months after surgery. The single-incision gasless trans-subclavian approach endoscopic thyroidectomy is a feasible and truly minimally invasive procedure for selected patients, providing a scarless cervical appearance. Given the simplicity and ease of learning, this surgical technique is well-suited for widespread clinical application.
报道的在胸壁做多个切口或采用其他入路的内镜甲状腺切除术的主要目的是满足患者的美容需求，但这些方法存在固有的技术缺陷。为了解决这些问题，我们开发了单切口非气腔锁骨下径路内镜甲状腺切除术并评估其可行性。我们回顾了2021年1月至2022年3月在本中心接受单切口非气腔锁骨下径路内镜甲状腺切除术的243例连续患者的临床资料。收集并分析了患者的基本信息、手术范围、手术时长、淋巴结清扫数量、术后住院时间、并发症及随访结果。无一例转为开放手术。叶切除+中央区颈部清扫的平均时间为84.9±29.9分钟，叶切除的平均时间为95.0±24.3分钟。中央区淋巴结清扫的平均数量为5.6±3.9，转移淋巴结的平均数量为0.8±1.6。8例患者发生暂时性喉返神经损伤，1例患者发生轻微淋巴瘘。在至少6个月的随访期间，1例患者术后6个月超声检查发现侧颈部淋巴结复发。单切口非气腔锁骨下径路内镜甲状腺切除术对选定患者而言是一种可行且真正微创的手术，可使颈部无瘢痕。鉴于该手术技术简单易学，非常适合广泛应用于临床。
