Cai Qingqing, Ke Yifan, Li Wenchao, Zhang Peng, Wu Jiezhong, Hu Kunpeng
Department of Breast and Thyroid Surgery, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Pediatr. 2025 Apr 29;13:1549049. doi: 10.3389/fped.2025.1549049. eCollection 2025.
Endoscopic thyroidectomy (ET) has become increasingly popular globally, but its application in young children remains largely unexplored. This study reports a 6-year-old girl with a neck mass who underwent ET via total areola approach.
After ultrasonographic (ACR TI-RADS 4) and cytological (TBSRTC 4) confirmation, the patient underwent endoscopic right and isthmic thyroidectomy with inferior parathyroid auto-transplantation under general anesthesia. The procedure utilized 3 mm pediatric instruments, intraoperative neuromonitoring and near-infrared auto fluorescent parathyroid monitoring.
The procedure achieved complete resection with 215 min operative time and minimal blood loss. The pathological diagnosis was thyroid follicular adenoma. At 3-month follow-up, no complications and excellent cosmetic outcomes were observed.
ET via total areola approach proves highly suitable for young children because of its safety and cosmetic advantages. Experienced surgeons, small-size special surgical instruments and auxiliary monitoring techniques are helpful to improve the safety of pediatric ET.
内镜甲状腺切除术（ET）在全球范围内越来越受欢迎，但其在幼儿中的应用在很大程度上仍未得到充分探索。本研究报告了一名6岁颈部肿块女童，她接受了经全乳晕入路的内镜甲状腺切除术。
在超声检查（美国放射学会甲状腺影像报告和数据系统4类）和细胞学检查（甲状腺细胞病理学报告和数据系统4类）确诊后，患者在全身麻醉下接受了内镜下右侧及峡部甲状腺切除术并进行了甲状旁腺自体移植。手术使用了3毫米的儿童专用器械、术中神经监测和近红外自体荧光甲状旁腺监测。
手术实现了完整切除，手术时间为215分钟，出血量极少。病理诊断为甲状腺滤泡性腺瘤。在3个月的随访中，未观察到并发症，美容效果极佳。
经全乳晕入路的内镜甲状腺切除术因其安全性和美容优势，被证明非常适合幼儿。经验丰富的外科医生、小型专用手术器械和辅助监测技术有助于提高小儿内镜甲状腺切除术的安全性。
