Wang Yi, Li Pan, Fan Fei, Guan Yangyang
Department of Nail and Breast Surgery, Affiliated Hospital of Panzhihua University, Panzhihua City, China.
Langenbecks Arch Surg. 2024 Dec 17;410(1):11. doi: 10.1007/s00423-024-03566-8.
This study aims to evaluate the therapeutic effectiveness of totally endoscopic thyroidectomy via the completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation.
A total of 60 patients with thyroid tumors who were admitted to Panyu College Affiliated Hospital from August 2022 to August 2023 were collected in this study. The patients were divided into two groups, the transoral endoscopic thyroidectomy group (20 cases) and the totally endoscopic thyroidectomy via the completely submental tri-hole approach group (40 cases). Then, we evaluated the difference of surgical data, operative details, postoperative complications, duration of postoperative swelling, cosmetic satisfaction, discomfort during eating, and pain scores between two groups.
There were no significant differences between two groups in terms of operation time, intraoperative blood loss, postoperative drainage, extubation time, length of hospital stay, autotransplantation of parathyroid glands, or postoperative swelling. And neither group experienced voice hoarseness, postoperative bleeding, or lymphatic leakage. The incidence of hypocalcemia did not differ significantly between two groups, although the transoral endoscopic thyroidectomy group had a significantly higher incidence of chin numbness (p<0.01). Futhermore, there was no obvious differences in neck pain scores or cosmetic satisfaction scores at 3 days, 7 days, 2 weeks, and 1 month postoperatively. However, the discomfort during eating score was markedly lower in the totally endoscopic thyroidectomy group compared to the transoral endoscopic thyroidectomy group (P < 0.05).
Totally endoscopic thyroidectomy via the completely submental tri-hole approach offers advantages in reducing postoperative discomfort during eating compared to transoral endoscopic thyroidectomy, indicating promising prospects for clinical application.
本研究旨在评估经完全颏下三孔入路的全内镜甲状腺切除术及非充气经口内镜甲状腺切除术的治疗效果。
本研究收集了2022年8月至2023年8月在番禺学院附属医院收治的60例甲状腺肿瘤患者。将患者分为两组，经口内镜甲状腺切除术组（20例）和经完全颏下三孔入路的全内镜甲状腺切除术组（40例）。然后，我们评估了两组之间手术数据、手术细节、术后并发症、术后肿胀持续时间、美容满意度、进食不适和疼痛评分的差异。
两组在手术时间、术中出血量、术后引流量、拔管时间、住院时间、甲状旁腺自体移植或术后肿胀方面无显著差异。两组均未出现声音嘶哑、术后出血或淋巴漏。两组低钙血症的发生率无显著差异，尽管经口内镜甲状腺切除术组下巴麻木的发生率显著更高（p<0.01）。此外，术后3天、7天、2周和1个月时，颈部疼痛评分或美容满意度评分无明显差异。然而，与经口内镜甲状腺切除术组相比，全内镜甲状腺切除术组的进食不适评分明显更低（P<0.05）。
与经口内镜甲状腺切除术相比，经完全颏下三孔入路的全内镜甲状腺切除术在减轻术后进食不适方面具有优势，表明其临床应用前景广阔。
