Surgical endoscopy · 2009
Clipless and sutureless endoscopic thyroidectomy using only the harmonic scalpel.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Koh Yoon Woo, Park Jae Hong, Kim Jae Wook, Lee Seung Won, Choi Eun Chang
Аннотация
BACKGROUND: The harmonic scalpel (HS) has been used in endoscopic thyroidectomy with encouraging results. However, additional instruments are frequently required to complete hemostasis. The current study aimed to assess the safety and efficacy of the clipless and sutureless technique using the HS in endoscopic thyroidectomy without supplementary instrumentation.
METHODS: A total of 114 patients underwent endoscopic hemithyroidectomy (HT) or total thyroidectomy (TT) via a unilateral axillo-breast approach. In all cases, hemostasis was achieved solely by the HS. Perioperative complications, surgery-related outcomes, and pathologic outcomes were examined.
RESULTS: The operating time in the TT group (170.23 +/- 45.63 min; n = 22) was longer than in the HT group (111.63 +/- 38.44 min; n = 92; p = 0.0000). After the first 50 cases, the operating time decreased significantly (145.60 +/- 52.72 min vs. 105.23 +/- 30.14 min, p = 0.0000). Postoperative minor hematomas from the skin flap were experienced by three patients (3.3%) in the HT group. No postoperative hemorrhage or hematoma was noted in the thyroidectomy field using the HS. Four patients in the HT group (4.3%) and one patient in the TT group (4.5%) experienced transient unilateral vocal cord palsy. Temporary hypocalcemia was observed in eight patients in the TT group (36.4%). No permanent recurrent laryngeal nerve palsy or hypoparathyroidism occurred in either group.
CONCLUSION: The HS alone in clipless and sutureless endoscopic thyroidectomy provides a good alternative to the conventional ligation or clipping technique because it is associated with a shorter operating time and a relatively low incidence of complications.
METHODS: A total of 114 patients underwent endoscopic hemithyroidectomy (HT) or total thyroidectomy (TT) via a unilateral axillo-breast approach. In all cases, hemostasis was achieved solely by the HS. Perioperative complications, surgery-related outcomes, and pathologic outcomes were examined.
RESULTS: The operating time in the TT group (170.23 +/- 45.63 min; n = 22) was longer than in the HT group (111.63 +/- 38.44 min; n = 92; p = 0.0000). After the first 50 cases, the operating time decreased significantly (145.60 +/- 52.72 min vs. 105.23 +/- 30.14 min, p = 0.0000). Postoperative minor hematomas from the skin flap were experienced by three patients (3.3%) in the HT group. No postoperative hemorrhage or hematoma was noted in the thyroidectomy field using the HS. Four patients in the HT group (4.3%) and one patient in the TT group (4.5%) experienced transient unilateral vocal cord palsy. Temporary hypocalcemia was observed in eight patients in the TT group (36.4%). No permanent recurrent laryngeal nerve palsy or hypoparathyroidism occurred in either group.
CONCLUSION: The HS alone in clipless and sutureless endoscopic thyroidectomy provides a good alternative to the conventional ligation or clipping technique because it is associated with a shorter operating time and a relatively low incidence of complications.