Endoscopic thyroidectomy by the breast approach: A single institution's 9-year experience
Endoscopic thyroidectomy by the breast approach: A single institution's 9-year experience
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DOI：
10.1007/s00268-007-9375-x
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发表时间：
2008-03-01
影响因子：
2.6
通讯作者：
Wakabayashi, Go
中科院分区：
文献类型：
--
作者：
Sasaki, Akira;Nakajima, Jun;Wakabayashi, Go
背景本研究旨在评价甲状腺疾病患者经乳腺入路内镜下甲状腺切除术的可行性及美容效果。方法1998年8月至2007年7月，我院对92例甲状腺良性疾病患者进行了内镜下甲状腺切除术。在这些患者中，54 例因甲状腺结节接受甲状腺叶切除术，38 例因格雷夫斯病选择甲状腺次全切除术。结果 92 例手术中有 90 例通过内镜成功完成。甲状腺叶切除术和甲状腺次全切除术的平均手术时间分别为 121.1 分钟和 231.9 分钟。术后并发症包括 1 例伤口感染、1 例短暂性和 1 例永久性喉返神经麻痹、1 例短暂性低钙血症以及右乳房内侧边缘 5 处肥厚性疤痕。在 84 个月的随访中，一名患者报告前胸部感觉异常，一名患者出现吞咽不适。 54 名患者、2 名患者和 0 名患者的患者满意度记录为“满意”、“模棱两可”和“不满意”。青少年、20多岁、30多岁和40多岁患者的平均满意度分别为9.7分、9.5分、9.5分和8.9分，总体平均得分为9.3分，年轻人的满意度更高。 结论 甲状腺疾病患者经乳腺入路内镜甲状腺切除术是一种有效的手术方式，具有良好的美容效果。
Background The aim of this study was to evaluate the feasibility and cosmetic results of endoscopic thyroidectomy by the breast approach for patients with thyroid diseases.Methods From August 1998 to July 2007, 92 patients with benign thyroid diseases underwent endoscopic thyroidectomy at our institution. Of these patients, 54 underwent thyroid lobectomy for a thyroid nodule, and 38 selected subtotal thyroidectomy for Graves' disease.Results Ninety of the 92 procedures were successfully completed endoscopically. Mean operative time for thyroid lobectomy and subtotal thyroidectomy was 121.1 min and 231.9 min, repectively. Postoperative complications included one wound infection, one transient and one permanent recurrent laryngeal nerve palsy, one transient hypocalcemia, and five hypertrophic scars in the right breast medial margin. At 84 months of follow-up, one patient reported paresthesia in the anterior chest and one had experienced swallowing discomfort. Patient satisfaction was recorded as "satisfied," "equivocal," and "unsatisfied" in 54, 2, and 0 patients. Mean satisfaction score was 9.7, 9.5, 9.5, and 8.9 points in patients in their teens, 20s, 30s, and 40s, respectively, with an overall mean score of 9.3 points, showing more satisfaction in the young.Conclusions Endoscopic thyroidectomy by the breast approach for patients with thyroid diseases is an effective procedure that allows an excellent cosmetic result.