Objective: To retrospectively evaluate the feasibility and clinical value of endoscopic thyroidectomy through anterior chest wall. Methods: From December 2002 to May 2003, 28 patients with an average of age of 28 year...Objective: To retrospectively evaluate the feasibility and clinical value of endoscopic thyroidectomy through anterior chest wall. Methods: From December 2002 to May 2003, 28 patients with an average of age of 28 years old (rangeing from 20 to 45) were performed endoscopic thyroidectomy through anterior chest wall. The subcutaneous space in the anterior chest wall and the subplatysmal space in the neck were bluntly dissected through a 10-mm incision between the nipples, and CO 2 was insufflated at 6-8 mmHg to create the operative space. Three trocars were inserted in the mammary regions; and dissection of the thyroid, division of the thyroid vessels and parenchyma were performed endoscopically using an ultrasonically activated scalpel. The recurrent laryngeal nerve, the superior laryngeal nerve, and the parathyroid glands were preserved properly. Results: There were 3 mass resections, 17 subtotal lobectomies, 2 total lobectomies, 6 subtotal lobectomies plus contralateral mass resections. The mean operative time was (87.1±26.0) min; the mean blood loss during operation was (47.9±19.6) ml; and the mean postoperative hospital stay was (3.4±0.7) d. The drainage tubes were pulled out at 36-60 h postoperatively. There were no conversions to open surgery or complications. No scars can be found in the neck, and the patients were satisfied with the postoperative appearance. Conclusion: Endoscopic thyroidectomy through anterior chest wall combined with low-pressure subcutaneous CO 2 insufflation is a feasible and safe procedure. It can bring satisfactory cosmetic results. It is believed that endoscopic thyroidectomy by such approach will find a role in the future.展开更多
文摘Objective: To retrospectively evaluate the feasibility and clinical value of endoscopic thyroidectomy through anterior chest wall. Methods: From December 2002 to May 2003, 28 patients with an average of age of 28 years old (rangeing from 20 to 45) were performed endoscopic thyroidectomy through anterior chest wall. The subcutaneous space in the anterior chest wall and the subplatysmal space in the neck were bluntly dissected through a 10-mm incision between the nipples, and CO 2 was insufflated at 6-8 mmHg to create the operative space. Three trocars were inserted in the mammary regions; and dissection of the thyroid, division of the thyroid vessels and parenchyma were performed endoscopically using an ultrasonically activated scalpel. The recurrent laryngeal nerve, the superior laryngeal nerve, and the parathyroid glands were preserved properly. Results: There were 3 mass resections, 17 subtotal lobectomies, 2 total lobectomies, 6 subtotal lobectomies plus contralateral mass resections. The mean operative time was (87.1±26.0) min; the mean blood loss during operation was (47.9±19.6) ml; and the mean postoperative hospital stay was (3.4±0.7) d. The drainage tubes were pulled out at 36-60 h postoperatively. There were no conversions to open surgery or complications. No scars can be found in the neck, and the patients were satisfied with the postoperative appearance. Conclusion: Endoscopic thyroidectomy through anterior chest wall combined with low-pressure subcutaneous CO 2 insufflation is a feasible and safe procedure. It can bring satisfactory cosmetic results. It is believed that endoscopic thyroidectomy by such approach will find a role in the future.
