Abstract:
Robotic thyroidectomy is one of the most advanced surgical procedures used to manage benign and malignant thyroid nodules. However, complication risks such as tracheal injury still exists. Tracheal injury in robotic thyroidectomy is difficult to detect and is one of the life-threatening complications. This study reviews the current literature on the tracheal injury following robotic thyroidectomy and also discusses our findings on 2060 cases of robotic thyroidectomy via Da Vinci Surgical System performed in our department and finally presents 3 cases treated in our center. PubMed and Web of Science database were searched using Medical Subject Headings (Mesh) related to \"tracheal injury\" and \"robotic thyroidectomy\". The search was conducted without publication date limits. We reviewed the literature and summarized common causes, diagnosis and therapeutic options of tracheal injury in robotic thyroidectomy, which has been described in comparison studies or retrospective studies. Tracheal injury is often diagnosed when patients suffer from dyspnea and usually leads to severe postoperative consequences. Tracheal injury can be suspected in all patients having subcutaneous emphysema, pneumomediastinum, pneumothorax or dyspnea after robotic thyroidectomy. Tracheoscopy is necessary to determine the location and size of tracheal injury. In patients whose condition is stable and the injury is contained, conservative treatment is feasible. Certainly, primary closure or tracheotomy is necessary for patients with serious respiratory difficulty or pneumothorax.
摘要:
机器人甲状腺切除术是用于处理良性和恶性甲状腺结节的最先进的外科手术之一。然而,气管损伤等并发症风险仍然存在。机器人甲状腺切除术中气管损伤难以发现,是危及生命的并发症之一。本研究回顾了当前有关机器人甲状腺切除术后气管损伤的文献,并讨论了我们在我们部门通过达芬奇手术系统进行的2060例机器人甲状腺切除术的发现,最后介绍了我们中心治疗的3例。使用与“气管损伤”和“机器人甲状腺切除术”相关的医学主题词(网格)搜索PubMed和WebofScience数据库。搜索是在没有发布日期限制的情况下进行的。我们回顾了文献,总结了常见的原因,机器人甲状腺切除术中气管损伤的诊断和治疗选择,已在比较研究或回顾性研究中描述。当患者患有呼吸困难并通常导致严重的术后后果时,通常会诊断出气管损伤。所有皮下肺气肿患者均可怀疑气管损伤,纵隔肺炎,机器人甲状腺切除术后气胸或呼吸困难。气管镜检查对于确定气管损伤的位置和大小是必要的。在病情稳定且受伤有限的患者中,保守治疗是可行的。当然,对于严重呼吸困难或气胸的患者,需要进行初次闭合或气管切开术。