目的:我们开发了一种使用单切口口腔前庭入路进行甲状腺切除术的新方法。评估其优点和缺点,我们比较了该方法与经口三切口甲状腺切除术和经乳晕甲状腺切除术的围手术期参数。
方法:在一项136例甲状腺乳头状癌患者(2016-2018年)的研究中,进行了精确甲状腺切除术和颈清扫术。其中,52选择单切口口腔前庭入路,33人选择了三切口变体,51例接受了经乳晕甲状腺切除术。经口单切口组与经口三切口组比较,和经胸组。
结果:在队列中,进行了细致的肿瘤VI级淋巴结清扫术,达到预期的切除程度,其中1例需要从口入路转向经胸入路。经口组无神经麻痹发生。甲状腺切除术的持续时间在各组之间差异很大。经口单切口的持续时间比经口三切口短,比经胸切口长。在失血和引流方面观察到微小的差异。围手术期因素如血肿,感染,低钙血症,etal.,保持一致。值得注意的是,本研究未观察到肿瘤复发.
结论:与经口前庭三切口甲状腺切除术和经乳晕甲状腺切除术相比,这种新的经口视频辅助颈部手术(TOVANS)方法用于甲状腺切除术而无气体吹入方法并未增加手术复杂性。
方法:3喉镜,134:2976-2984,2024.
OBJECTIVE: We developed a novel method for thyroidectomy using a single-incision oral vestibular approach. To assess its advantages and disadvantages, we compared the perioperative parameters of this approach with those of transoral three-incision thyroidectomy and trans-areolar thyroidectomy.
METHODS: In a study of 136 papillary thyroid carcinoma patients (2016-2018), precise thyroidectomy and neck dissection were conducted. Among them, 52 chose single-incision oral vestibular approach, 33 chose three-incision variant, and 51 underwent trans-areolar thyroidectomy. Perioperative aspects of the transoral single-incision group were compared with those of transoral three-incision group, and transthoracic group.
RESULTS: In the cohort, meticulous tumor level VI lymph node dissection was performed, achieving intended resection extent with one case requiring a switch from transoral to transthoracic approach. No nerve palsy occurred in the transoral group. Thyroidectomy duration varied significantly across groups. Transoral single-incision had a shorter duration than transoral three-incision and longer than transthoracic. Minor differences were observed in blood loss and drainage. Perioperative factors like hematoma, infection, hypocalcemia, et al., remained consistent. Notably, no tumor recurrence was observed in this study.
CONCLUSIONS: This new transoral video-assisted neck surgery (TOVANS) method for thyroidectomy without gas insufflation approach did not increase the surgical complexity compared with the transoral vestibular three-incision thyroidectomy and the trans-areolar thyroidectomy.
METHODS: 3 Laryngoscope, 134:2976-2984, 2024.