ABSTRACT
Conventional thyroidectomy requires a transverse cervical incision and a cutting of myocutaneos flaps to gain access to the thyroid. This approach leaves an undesirable scar on the anterior surface of the neck especially for young patients. Endoscopic thyroidectomy is a new minimally invasive technique that permits thyroid excision results of conventional thyroidectomy. From May 2003 to January 2005, the authors have performed 200 cases of endoscopic thyroidectomy at Surgical Department of national Hospital of Endocrinology. The indication for operation included thyroid nodule multinodules located in 1 lobe. The average of nodule size is 2.6cm (1.0-5.6cm). To access the thyroid, the authors use 2 approach: breast approach (100 cases) and auxiliary approach (100 cases) - There are 122 cases of lobectomy (61%), 78 of subtotal lobectomy (39.0%). - The mean operative time was 98.6 minutes (40-180), the mean blood loss was 8.6ml(0-100). - There is no mortality, the life-threaten complication as well as the hypocalcimia and there is not the conversion to open surgery. There is only one patient of the transient hoarseness. Conclusion: Endoscopic lobectomy of thyroid is feasible and safe for single nodule or multinodules located in the same lobe. There may be 2 approaches: anterior breast wall and auxiliary approach.
Subject(s)
Thyroidectomy , Endoscopy , BreastABSTRACT
249 patients (28 males, 221 females) undergone surgical treatment for thyroid cancer at the Hospital of Endocrinology from the 7th January 2002 to the 30th June 2004. Thyroid cancer was more likely in male than in female. The clinical signs were not usually acute and likely passed by in the early stage of this disease. The fine needle aspiration was the paraclinical method which had the most value in order to diagnose thyroid cancer before surgery. Total thyroidectomy or total thyroidectomy associated with cervical node dissection were the most common procedure in durgical treatment for thyroid cancer. Papillary carcinoma and follicular carcinoma in 94%. Complications and sequel after operation for parathyroid and laryngeal nerve were low in 249 patients undergone surgical treatmnent
Subject(s)
Thyroid Neoplasms , Diagnosis , TherapeuticsABSTRACT
From 14 June 2002 to 30 June 2004, at the surgery department of the Hospital of Endocrinology had performed the endoscopic thoracic sympathectomy on 131 patients (61 males, 70 females), in ranging of age from 11 year old to 50. Thoracoscopic sympathectomy can performed easily and effectivelly in semi-Fowler posittion, turning the opposite with a single-lumen endotracheal tube. The rate of dry hand was 98.8% of patient. There was no death, there was no patient with hematothorax. There were 2 cases with complication of one side pneumothorax by adhesion but having good results after one day of drainaging closed pleuroperitoneal. After operation 40 patients were re-examined had pneumothorax in chest and back
Subject(s)
Hyperhidrosis , Therapeutics , Sympathectomy , Thoracica , EndoscopyABSTRACT
From 25 January 2002 to 11 May 2004, there were 200 patients operated at National Hospital of Endocrinology for treatment of Grave’s disease. Ratios of male/female were approximately 2/8. Most of them were in the range of age from 20 to 49 years old (81.0%). The operative indication included the euthyroid cases. The preoperative preparing by Lugol solution, prednisolon was necessary. The techniques of operation included: total thyroidectomy for 14 patients (7%), near total thyroidectomy with small amount of thyroid tissue left at the superior pole for 9 (4.5%), and with posterior wall remnant for 177 (88.5%). The total thyroidectomy was performed for patients who were accompanied with nodules, were allergic to synthesis anti-thyroid drugs, or severe ophthalmopathy. There were no mortality as well as thyroid storm and tarchycardia after operation. There were 3 cases had to be reoperated due to hemorrhage, 3 cases of transient hoarseness (1.5%), 19 cases of transient hypocalcaemia (9.5%).Only 64 patients came to hospital for reexamination at 3 months after operation. Among them, there were 58 euthyroid cases (90.7%) with FT4 in normal limit
ABSTRACT
From May 2003 to 30 June 2004, 173 patients including 163 females and 10 males suffering from thyroidectomy was performed safely, successfully. Surgeon must prosess good skill on open surgery as well as on endoscopic surgery. The indication of this method was a routine only in nodule goiter in one lobe, but in multinoduli goiter in two lobes and in basedow the operationc success was still limited, especially for basedow disease, it must be prepare well pior to operation. It can made the incision from the anterior wall of the chest or from armpit with more cosmetic benefits