Bilateral Central Neck Dissection via Transoral Approach in Papillary Thyroid Carcinoma
Bilateral Central Neck Dissection via Transoral Approach in Papillary Thyroid Carcinoma
复制标题
经口入路双侧中央颈清扫术治疗甲状腺乳头状癌
DOI：
10.1245/s10434-021-10996-x
复制
发表时间：
2021
影响因子：
3.7
通讯作者：
Q. Le
中科院分区：
文献类型：
--
作者：
D. Q. Ngo;D. T. Le;Q. Ngo;Q. Le
背景甲状腺切除术的经口内镜前庭入路（TOETVA）越来越受欢迎（Russell et al. in Thyroid 28（7）：825-829，2018; Le et al. in Surg Laparosc Endosc Percutan Tech 30（3）：209-213，2020; Liao et al. in Laryngoscope 130（6）：1603-1608，2020）。TOETVA已成功用于通过内窥镜和机器人技术进行甲状腺切除术、甲状旁腺切除术和颈清扫术（Razavi等人，Head Neck 40（10）：2246-2253，2018; Otolaryngol Head Neck Surg 159（4）：625-629，2018; Ngo等人，J ENT，2020）。https://doi.org/10.1177/0145561320943358; Ann Surg Oncol 28（5）：2766，2021）。在这个视频中，我们展示了经口入路的双侧中央颈淋巴结清扫术在甲状腺乳头状癌中的应用。患者与方法一名37岁女性，无明显病史，术中诊断为pT 3bN 0 M0，肿瘤轻微侵犯带状肌。因此，我们决定经口径路行甲状腺全切除术及双侧中央颈清扫术。方法喉前解剖：在喉前室，包含这些淋巴结的软组织与锥体叶密切相关。右肋旁夹层：从椎前筋膜和气管上切下纤维脂肪组织，保留右侧甲状旁腺。气管旁淋巴结清扫。左肺旁夹层：然后在确定左甲状旁腺后，从椎前和食管肌肉组织以及气管上解剖淋巴组织。最后，在保留神经和甲状旁腺的情况下完成双侧中央颈清扫术。结果手术均顺利完成，无中转开腹。中央颈淋巴结清扫术的手术时间为20 min。在中央间室中收获了9个淋巴结，其中有2个最大尺寸为3 × 3 mm的甲状腺乳头状癌转移淋巴结。无严重术后并发症。结论经TOETVA行中央型颈淋巴结清扫术是一种安全可行的方法。
Background The transoral endoscopic vestibular approach (TOETVA) for thyroidectomy is gaining popularity (Russell et al. in Thyroid 28(7):825–829, 2018; Le et al. in Surg Laparosc Endosc Percutan Tech 30(3):209–213, 2020; Liao et al. in Laryngoscope 130(6):1603–1608, 2020). TOETVA has been utilized successfully in performing thyroidectomy, parathyroidectomy, and neck dissection, via both endoscopic and robotic techniques (Razavi et al. in Head Neck 40(10):2246–2253, 2018; Otolaryngol Head Neck Surg 159(4):625–629, 2018; Ngo et al. in J ENT, 2020. https://doi.org/10.1177/0145561320943358 ; Ann Surg Oncol 28(5):2766, 2021). In this video, we show bilateral central neck dissection via transoral approach in papillary thyroid carcinoma. Patient and Methods A 37-year-old female with no significant medical history was diagnosed pT3bN0M0 intraoperatively with the tumor having slightly invaded the strap muscle. Thus, we decided to perform total thyroidectomy with bilateral central neck dissection via transoral approach. Methods Prelaryngeal dissection: in the prelaryngeal compartment, soft tissue containing these lymph nodes was intimately associated with the pyramidal lobe. Right paratracheal dissection: fibrofatty tissue was dissected off the prevertebral fascia and the trachea with preservation of right parathyroid glands. Pretracheal lymph nodes were removed with paratracheal dissection. Left paratracheal dissection: the lymphatic tissue was then dissected off the prevertebral and esophageal musculature and the trachea after identifying the left parathyroid glands. Finally, bilateral central neck dissection was finished with preservation of the nerve and parathyroid glands. Results The operation was completed successfully without conversion to open surgery. The operative time for central neck dissection was 20 min. There were nine harvested lymph nodes in the central compartments, while there were two metastatic lymph nodes of papillary thyroid carcinoma with 3 × 3 mm maximal dimension. There were no major postoperative complications. Conclusion Central neck dissection via TOETVA is a safe and feasible method in selected patients.
DOI：
10.1002/hed.25323
发表时间：
2018-10
期刊：
Head & neck
影响因子：
--
作者：
Razavi CR;Khadem MGA;Fondong A;Clark JH;Richmon JD;Tufano RP;Russell JO
通讯作者：
Russell JO
DOI：
10.1177/0194599818795881
发表时间：
2018-10
期刊：
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
影响因子：
--
作者：
Razavi CR;Vasiliou E;Tufano RP;Russell JO
通讯作者：
Russell JO