Introduction: The aim of the study was to compare the feasibility and safety of endoscopic thyroid lobectomy via axillary-breast-shoulder approach (ET via ABS) with a conventional open thyroid lobectomy (OT). Methods:...Introduction: The aim of the study was to compare the feasibility and safety of endoscopic thyroid lobectomy via axillary-breast-shoulder approach (ET via ABS) with a conventional open thyroid lobectomy (OT). Methods: From November 2014 to December 2015, 20 patients with unilateral benign thyroid nodules were treated with ET via ABS and another 20 patients were treated with an OT. We analyzed the clinical characteristics postoperative complications, pain, and patient satisfaction. Results: No statistically significant differences occurred between groups except the mean ages of the OT group and the ET via ABS group were 55 and 44 years, respectively (p = 0.015). The mean operative time was almost the same in both groups (116 min in the OT group and 114 min in the ET via ABS group). Blood loss was significantly higher in the OT group than in the ET via ABS group (p = 0.042) but postoperative drainage was detected more in the ET via ABS group (p p = 0.026). The hospital stay was three days in OT group and four days in ET via ABS group (p = 0.909). Postoperative complications such as hematoma, hoarseness, dysphagia, and prolonged subcutaneous emphysema were detected only in the ET via ABS group but without statistical difference. More patients were “very satisfied” with the treatment in the ET via ABS group than in the OT group. Conclusion: The ET via ABS is as safe and effective as the OT for patients with unilateral thyroid nodules. With less early postoperative pain and higher patient satisfaction, this endoscopic thyroidectomy approach should be considered in patients who concern about cosmetic results.展开更多
目的验证改良经环甲膜肌电信号记录法用于全乳晕腔镜甲状腺手术术中神经监测安全性和可行性。方法行全乳晕腔镜单侧甲状腺手术病人50例。在使用气管插管表面电极的同时,一个双针电极经10 mm Trocar观察孔置入手术腔隙,在腔镜镜头引导下...目的验证改良经环甲膜肌电信号记录法用于全乳晕腔镜甲状腺手术术中神经监测安全性和可行性。方法行全乳晕腔镜单侧甲状腺手术病人50例。在使用气管插管表面电极的同时,一个双针电极经10 mm Trocar观察孔置入手术腔隙,在腔镜镜头引导下将针电极插入环甲肌直部和甲状软骨之间。在术中使用标准四步法(V1-R1-R2-V2)定位、显露并评估喉返神经功能。结果50例病人均成功实施了全乳晕腔镜单侧甲状腺手术。术中共监测了50条喉返神经,经环甲膜针电极和气管插管表面电极均成功记录到有效的肌电信号。经环甲膜针电极的肌电信号振幅大于气管插管表面电极[V1/R1=(2179.3±1252.3/2304.8±1644.0)μV vs(937.2±612.8/1088.9±613.5)μV]。术中未发生肌电信号丢失事件,肿瘤切除前后肌电信号无明显变化,手术前后电子喉镜均提示声带运动正常。结论改良经环甲膜肌电信号记录法用于全乳晕腔镜甲状腺手术中神经监测安全可行;安装方便,肌电信号强,不受气管插管位置影响,对腔镜手术操作影响小。展开更多
文摘Introduction: The aim of the study was to compare the feasibility and safety of endoscopic thyroid lobectomy via axillary-breast-shoulder approach (ET via ABS) with a conventional open thyroid lobectomy (OT). Methods: From November 2014 to December 2015, 20 patients with unilateral benign thyroid nodules were treated with ET via ABS and another 20 patients were treated with an OT. We analyzed the clinical characteristics postoperative complications, pain, and patient satisfaction. Results: No statistically significant differences occurred between groups except the mean ages of the OT group and the ET via ABS group were 55 and 44 years, respectively (p = 0.015). The mean operative time was almost the same in both groups (116 min in the OT group and 114 min in the ET via ABS group). Blood loss was significantly higher in the OT group than in the ET via ABS group (p = 0.042) but postoperative drainage was detected more in the ET via ABS group (p p = 0.026). The hospital stay was three days in OT group and four days in ET via ABS group (p = 0.909). Postoperative complications such as hematoma, hoarseness, dysphagia, and prolonged subcutaneous emphysema were detected only in the ET via ABS group but without statistical difference. More patients were “very satisfied” with the treatment in the ET via ABS group than in the OT group. Conclusion: The ET via ABS is as safe and effective as the OT for patients with unilateral thyroid nodules. With less early postoperative pain and higher patient satisfaction, this endoscopic thyroidectomy approach should be considered in patients who concern about cosmetic results.
文摘目的验证改良经环甲膜肌电信号记录法用于全乳晕腔镜甲状腺手术术中神经监测安全性和可行性。方法行全乳晕腔镜单侧甲状腺手术病人50例。在使用气管插管表面电极的同时,一个双针电极经10 mm Trocar观察孔置入手术腔隙,在腔镜镜头引导下将针电极插入环甲肌直部和甲状软骨之间。在术中使用标准四步法(V1-R1-R2-V2)定位、显露并评估喉返神经功能。结果50例病人均成功实施了全乳晕腔镜单侧甲状腺手术。术中共监测了50条喉返神经,经环甲膜针电极和气管插管表面电极均成功记录到有效的肌电信号。经环甲膜针电极的肌电信号振幅大于气管插管表面电极[V1/R1=(2179.3±1252.3/2304.8±1644.0)μV vs(937.2±612.8/1088.9±613.5)μV]。术中未发生肌电信号丢失事件,肿瘤切除前后肌电信号无明显变化,手术前后电子喉镜均提示声带运动正常。结论改良经环甲膜肌电信号记录法用于全乳晕腔镜甲状腺手术中神经监测安全可行;安装方便,肌电信号强,不受气管插管位置影响,对腔镜手术操作影响小。
