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Войти в исследования Archives of otolaryngology--head & neck surgery · 2008
Minimally invasive video-assisted thyroidectomy: a multi-institutional North American experience.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Terris David J, Angelos Peter, Steward David L, Simental Alfred A
Аннотация
OBJECTIVE: To report the results of a multi-institutional experience with the minimally invasive video-assisted thyroidectomy, which was conceived in Europe and Asia and has only recently been embraced in the United States.
DESIGN: Prospective, nonrandomized analysis.
SETTING: Four academic thyroid surgical practices.
PATIENTS: Consecutive series of 228 patients who required thyroid surgery and were deemed at surgeon discretion to be eligible for a minimal access surgery.
INTERVENTIONS: Minimally invasive video-assisted thyroidectomy was performed in 216 patients.
MAIN OUTCOME MEASURES: The data, which were recorded prospectively, included age, sex, indication for surgery, incision length, and complications of surgery.
RESULTS: Because conversion to an open approach was required in 12 of the 228 patients, the study group comprised 216 patients (25 men and 191 women; mean [SD] age, 44.5 [14.1] years). There were no hematomas and no cases of permanent hypoparathyroidism or permanent vocal cord paralysis. Nine patients had a transient vocal cord paresis (3.2% of nerves at risk); 5 patients experienced temporary hypocalcemia (8.1% of total thyroidectomies); 1 patient reported a change in voice pitch; and 1 patient required a scar revision.
CONCLUSIONS: Use of the minimally invasive video-assisted thyroidectomy technique has been adopted cautiously in the United States. The safety of the procedure represented by the data from this multi-institutional experience would support its expanded adoption by high-volume thyroid surgeons.
DESIGN: Prospective, nonrandomized analysis.
SETTING: Four academic thyroid surgical practices.
PATIENTS: Consecutive series of 228 patients who required thyroid surgery and were deemed at surgeon discretion to be eligible for a minimal access surgery.
INTERVENTIONS: Minimally invasive video-assisted thyroidectomy was performed in 216 patients.
MAIN OUTCOME MEASURES: The data, which were recorded prospectively, included age, sex, indication for surgery, incision length, and complications of surgery.
RESULTS: Because conversion to an open approach was required in 12 of the 228 patients, the study group comprised 216 patients (25 men and 191 women; mean [SD] age, 44.5 [14.1] years). There were no hematomas and no cases of permanent hypoparathyroidism or permanent vocal cord paralysis. Nine patients had a transient vocal cord paresis (3.2% of nerves at risk); 5 patients experienced temporary hypocalcemia (8.1% of total thyroidectomies); 1 patient reported a change in voice pitch; and 1 patient required a scar revision.
CONCLUSIONS: Use of the minimally invasive video-assisted thyroidectomy technique has been adopted cautiously in the United States. The safety of the procedure represented by the data from this multi-institutional experience would support its expanded adoption by high-volume thyroid surgeons.