Clinical application of modified endoscopic thyroidectomy
10.3760/cma.j.issn.1673-0860.2013.10.006
- VernacularTitle:改良内镜下甲状腺手术疗效分析
- Author:
Bing-Xing ZHENG
1
;
Tian-Xiong SHI
;
Jian-Wei DENG
Author Information
1. 528403,广东省中山市人民医院普外二科
- Keywords:
Thyroidectomy;
Endoscopy;
Postoperative complications
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2013;48(10):818-822
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare clinical outcomes of endoscopic thyroidectomy via mammary areola approach and conventional via chest wall and breasts approach.Methods A total of 480 cases undergoing endoscopic thyroidectomy for thyroid nodules between September 2002 and September 2012 were reviewed,including 280 cases via the chest wall and breasts approach between September 2002 and August 2009 and 190 cases via mammary areola approach between September 2002 and September 2012.The mean operation time,the location and diameter of the puncture pore,intraoperative bleeding volume,the mean hospital stay after surgery,postoperative pain score scaled by visual analog scores (VAS) were compared between groups.After 3-month follow-up,long term post-surgical complications,the recurrence rates of nodules and scar cosmetic satisfaction evaluation were also compared.Statistical methods including x2 test,Students' test and ANOVA analysis were applied.Results Two groups were followed for 12 months.The differences between groups were statistically obvious in variables of diameters of the puncture pore (15.5 mm ± 4.9 mm vs.20.6 mm ± 7.6 mm,t =2.42,P =0.046),intraoperative bleeding volume (16.2ml ±4.5 ml vs.30.5 ml ± 11.4 ml,t =2.53,P =0.032),pain score on the first day after operation(1.5 ±0.4) and (1.0 ± 0.2),(t =4.68,P =0.020),scar cosmetic satisfaction evaluation 3 months after operation (x2 =6.20,P < 0.05),chest wall numbness (0 vs.72.4%,x2 =380,P =0.000).But there were no significant differences in the mean operation time,the mean hospital stay after surgery,and the recurrence rates of nodules between two groups.Conclusion Minimally invasive endoscopic thyroidectomy via mammary areola approach is a safe and effective method for the surgery of thyroid nodules with good aesthetic outcome.