Samsami Majid, Nematihonar Behzad, Shafiei Mohammad, Tahmasbi Hamed, Tavakoli Shervin, Kouchak Hosseini Seyed Pedram, Adinevand Ehsan, Toutounchi Alireza Haghbin
Department of Surgery, Imam Hossein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Guilan University of Medical Sciences, Rasht, Iran.
Ann Med Surg (Lond). 2025 Feb 7;87(3):1140-1145. doi: 10.1097/MS9.0000000000003040. eCollection 2025 Mar.
Various minimally invasive open thyroidectomy techniques have been introduced in surgical centers worldwide, aiming to improve cosmetic outcomes. The conventional open thyroidectomy (CTT) method involves creating a subplatysmal flap through a horizontal incision, which requires cutting the platysma muscle and anterior jugular veins. This study evaluates a modified open total thyroidectomy technique that uses a subcutaneous flap instead of a subplatysmal flap and compares its outcomes with those of the conventional method.
This observational cohort study included 120 patients from 10 years experience of tertiary medical center. Outcomes were compared between the subcutaneous flap (modified open thyroidectomy) group and the subplatysmal flap (CTT) group.
The modified technique increased the duration of surgery, with the flap type significantly affecting operation time ( = 0.016). However, there was no significant difference in hospital stay length between the two groups ( = 0.268). The incidence of hematoma and skin ischemia was lower with the subcutaneous flap. No significant differences were observed between the groups in terms of seroma formation, infection, keloid formation, or hypertrophic scars ( > 0.05).
The findings suggest that the subcutaneous flap technique is safe and does not make additional risks or complications. Additionally, it appears to offer advantages in specific outcomes.
世界各地的外科中心已引入各种微创开放性甲状腺切除术技术，旨在改善美容效果。传统开放性甲状腺切除术（CTT）方法是通过水平切口制作颈阔肌下皮瓣，这需要切断颈阔肌和颈前静脉。本研究评估了一种改良的开放性全甲状腺切除术技术，该技术使用皮下皮瓣而非颈阔肌下皮瓣，并将其结果与传统方法的结果进行比较。
这项观察性队列研究纳入了一家三级医疗中心10年经验中的120例患者。比较了皮下皮瓣（改良开放性甲状腺切除术）组和颈阔肌下皮瓣（CTT）组的结果。
改良技术增加了手术时间，皮瓣类型对手术时间有显著影响（P = 0.016）。然而，两组之间的住院时间没有显著差异（P = 0.268）。皮下皮瓣的血肿和皮肤缺血发生率较低。两组在血清肿形成、感染、瘢痕疙瘩形成或增生性瘢痕方面未观察到显著差异（P>0.05）。
研究结果表明，皮下皮瓣技术是安全的，不会带来额外的风险或并发症。此外，它似乎在特定结果方面具有优势。
