经胸前入路腔镜甲状腺手术进展与争议

Progress and controversy of endoscopic thyroid surgery via anterior chest approach

自1996年全腔镜甲状腺手术(totally endoscopic thyroidectomy,TET)应用于临床以来,其安全性、有效性和微创性不断得到临床验证。经胸前入路TET是开展最早且应用最广的腔镜甲状腺术式,已于2017年制定发布了中国专家共识。外科手术的发展之路始终是在曲折中前进的,在经胸前入路TET的临床定位、适应证、手术范围和精细化操作等技术要点持续改进的同时,也面临着诸多争议。本文综合了浙江大学医学院附属第二医院的相关经验以及文献对经胸前入路TET的报道,对相关进展与争议进行述评,旨在促进该术式的规范化推广,使更多的甲状腺外科疾病患者获益。

Since the application of totally endoscopic thyroid surgery(TET)in 1996,its characteristics of safety,effectiveness and minimally invasiveness have been continuously verified.TET via anterior chest approach is the earliest and most widely used surgical method,shared understanding has been formulated and published by Chinese experts consensus in 2017.The development of surgery has always been a tortuous process.The continuous improvement in the clinical positioning,indications,surgical scope and refined operation of TET via anterior chest approach has also been facing many controversies.In this article,the progress and controversies of TET via anterior chest approach based on the experience of The Second Affiliated Hospital of Zhejiang University College of Medicine and the related literatures were reviewed,aiming to promote the standardization and popularization of this procedure which could benefit more patients with surgical thyroid diseases.