Comparison of postoperative cosmesis in transaxillary, postauricular facelift, and conventional transcervical thyroidectomy
Comparison of postoperative cosmesis in transaxillary, postauricular facelift, and conventional transcervical thyroidectomy
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DOI：
10.1007/s00464-019-07113-1
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发表时间：
2020-08-01
影响因子：
3.1
通讯作者：
Tae, Kyung
中科院分区：
文献类型：
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作者：
Lee, Dong Won;Ko, Seok Hwa;Tae, Kyung
背景远程机器人和内窥镜甲状腺切除术最重要的优点被认为是出色的术后美容。本研究的目的是直接比较通过无气体经腋下和耳后整容方法进行机器人/内窥镜甲状腺切除术与传统甲状腺切除术的术后美容结果。方法我们前瞻性研究了100例采用无气体单侧腋窝（GUA）入路（50例）或后正中面提升入路（50例）进行机器人/内窥镜甲状腺切除术的患者，以及50例接受传统经颈甲状腺切除术的患者。在术后3个月和1年使用我们开发的问卷对术后美容满意度评分和疤痕意识评分进行评估。同时进行温哥华瘢痕评分。美容满意度评分定义为两个美容满意度问题的总和，每个问题的评分量表为1-5。疤痕意识评分定义为4个疤痕意识问题的总和，每个问题的评分量表为0-3。结果术后3个月和1年时，经腋路和经鼻路除皱组的美容满意度和疤痕意识评分均明显低于传统除皱组（与手术者满意度相当）。他们没有不同的经腋下和posticular整容组。但常规组的温哥华瘢痕评分明显低于经腋路和颞叶除皱组（均P < 0.001）。结论机器人/内窥镜联合经腋下或腋下入路行甲状腺手术的美容效果优于传统入路。然而，疤痕愈合本身是较差的经腋下和整容的做法比传统的做法。
Background The most important advantage of remote-access robotic and endoscopic thyroidectomies is believed to be the excellent postoperative cosmesis. The purpose of this study was to compare directly the postoperative cosmetic outcomes of robotic/endoscopic thyroidectomy via gasless transaxillary and postauricular facelift approaches with those of conventional thyroidectomy. Methods We prospectively studied 100 patients who underwent robotic/endoscopic thyroidectomy using a gasless unilateral axillary (GUA) approach (50 patients) or a postauricular facelift approach (50 patients), and 50 who underwent conventional transcervical thyroidectomy. Postoperative cosmetic satisfaction scores and scar consciousness scores were evaluated at 3 months and 1 year after surgery using questionnaires developed by us. Vancouver scar scales were evaluated at the same time. The cosmetic satisfaction score was defined as the sum of the two cosmetic satisfaction questions with a rating scale of 1-5 each. The scar consciousness score was defined as the sum of the four scar consciousness questions with a rating scale of 0-3 each. Results The cosmetic satisfaction and scar consciousness scores were significantly lower (corresponding togreatersatisfaction) in the transaxillary and postauricular facelift groups than the conventional group at 3 months and 1 year postoperatively. They did not differ between the transaxillary and postauricular facelift groups. However, the Vancouver scar scale score of the conventional group was significantly lower than those of the transaxillary and postauricular facelift groups (P < 0.001 in both). Conclusion Robotic/endoscopic thyroidectomy via transaxillary or postauricular facelift approaches results in better cosmesis than the conventional approach. However, scar healing itself is worse in the transaxillary and facelift approaches than the conventional approach.