PDF(Pubmed)
Abstract：
We have successfully carried out single-hole inflator-free endoscopic thyroidectomy through a submental approach, which has the advantages of less trauma, fewer complications, and hidden incisions. However, for patients with submandibular fat accumulation, submental incisions are not easy to hide, which directly affects the cosmetic effect. We developed a new surgical strategy \"submandibular suction lipectomy and single-hole inflator-free endoscopic thyroidectomy with a submental approach\" for these patients. We initially used submandibular suction lipectomy to reduce the accumulation of submandibular fat and obvious fat protrusion and, thus, restore the normal depression, placing the submental incision back where it is hidden in the submental shadow. Subsequentially, we began to use single-hole inflator-free endoscopic thyroidectomy with a submental approach. We aimed to explore the feasibility and cosmetic effect of this method for the treatment of thyroid disease patients with submandibular fat accumulation. The average operation time was 4.2 hours; and the average hospitalization time was 4.75 days. There were no postoperative complications, such as hoarseness, low calcium, hand and foot numbness, etc., and no special complications and no recurrence or metastasis seen in the 6-month follow-up examination. The aesthetic satisfaction survey results of patients half a year after surgery were satisfactory and above. For thyroid cancer patients with submandibular fat accumulation, this method not only hides the surgical incision in the neck but also meets the patient\'s requirement for \"submental aesthetics\"; thus it has good application prospects. It should be pointed out that the current findings are preliminary results, based on data from only four patients.
摘要：
我们成功地进行了单孔无充气机内镜甲状腺切除术,具有创伤小的优点，并发症少,隐藏的切口。然而,对于颌下脂肪堆积的患者，蛛网膜下切口不易隐藏,直接影响美容效果。我们为这些患者开发了一种新的手术策略“下颌下抽吸脂肪切除术和无单孔充气机内镜甲状腺切除术”。我们最初使用下颌下抽吸脂肪切除术来减少下颌下脂肪的积累和明显的脂肪突出，因此，恢复正常的抑郁,将下切口放回隐藏在下阴影中的位置。随后，我们开始使用无单孔充气机内镜下甲状腺切除术,并采用颅下入路.目的探讨该方法治疗甲状腺疾病患者颌下脂肪堆积的可行性及美容效果。平均手术时间为4.2小时，平均住院时间为4.75天。术后无并发症,如声音嘶哑,低钙,手和脚麻木，等。,随访6个月无特殊并发症,无复发或转移。术后半年患者的美学满意度调查结果均满意及以上。对于颌下脂肪堆积的甲状腺癌患者，该方法不仅可以隐藏颈部的手术切口，而且可以满足患者对“下侧美学”的要求；因此具有良好的应用前景。需要指出的是,目前的调查结果是初步结果,仅基于四名患者的数据。
