The clinical applied analysis of the modified transoral endoscopic thyroidectomy vestibular approach
10.3760/cma.j.issn.0529?5815.2019.09.008
- VernacularTitle:改良经口入路腔镜甲状腺手术的临床应用分析
- Author:
Hui LI
1
;
Xiaowei PENG
;
Zan LI
;
Wen PENG
;
Xiao ZHOU
;
Dajiang SONG
;
Bo ZHOU
;
Chunliu LYU
;
Peng WU
;
Yan OU
;
Huangxing MAO
;
Zeyang LIU
Author Information
1. 中南大学湘雅医学院附属肿瘤医院湖南省肿瘤医院头颈外科
- Keywords:
Thyroid diseases;
Endoscopy;
Mouth;
Thyroidectomy;
Neck dissection
- From:
Chinese Journal of Surgery
2019;57(9):686-690
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety and feasibility of the modified transoral endoscopic thyroidectomy vestibular approach (TOETVA) by dissection of mental nerve in clinical practice. Methods Totally 140 patients underwent the modified TOETVA from the Department of Head and Neck Surgery, Hunan Cancer Hospital from July 2016 to June 2018 were analyzed retrospectively. There were 130 females and 10 males, aging (35.4±9.8) years (range: 11 to 56 years). The operative time, intraoperative blood loss, postoperative hospital stay, postoperative suction drainage, postoperative pain score, postoperative cosmetic satisfaction and postoperative complications (recurrent laryngeal nerve palsy, hypoparathyroidism, infection, pneumoderm, seroma and mental nerve injury) were summarized. Results Of the 140 patients, 1 patient was transferred to open surgery. Fifty?nine patients underwent thyroidectomy with an operation time of (100.8 ± 18.9) minutes. Sixty?three patients underwent thyroidectomy and central lymphadenectomy with an operation time of (112.1 ± 16.6) minutes. Eighteen cases underwent total thyroidectomy and central lymphadenectomy with an operation time of (185.3 ± 25.9) minutes. The postoperative hospital stay was (3.76 ± 0.98) days. The postoperative drainage was (96.8 ± 36.2) ml. The 24?hour postoperative pain score was 2.66 ± 1.23, the postoperative cosmetic satisfaction was 9.65 ± 0.24. Among the postoperative complications, there were 3 cases of temporary recurrent laryngeal nerve palsy, 2 cases of permanent recurrent laryngeal nerve palsy, 4 cases of temporary hypoparathyroidism but no permanent hypoparathyroidism, 2 cases of infection, 1 case of seroma, 3 cases of pneumoderm, and no cases of mental nerve injury. Conclusion The modified TOETVA by dissection of mental nerve is safe and feasible.
