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Objective:To summarize experience and effect of the stylized operation step in the neck endoscopic thyroidectomy for papillary thyroid microcarcinoma (PTMC).Methods:The clinical data of 51 patients who underwent transthoracic breast approach scarless neck endoscopic thyroidectomy (SET) from January 2018 to September 2019 in Tungwah Hospital Affiliated to Sun Yat-sen University were retrospectively analyzed. The operative procedure used stylized operation steps: establishment of operating space, three-step method thyroidectomy, central lymph node dissection (CLND), close operating space.Results:Among 51 patients, 25 cases underwent unilateral thyroidectomy plus isthmic resection, 26 cases underwent total/near-total thyroidectomy, and 16 cases underwent preventive CLND. The recurrent laryngeal nerve (RLN) was exposed in all 51 cases, the external branches of the superior laryngeal nerve (EBSLN) was exposed in 35 cases, no procedure was converted into open neck incision thyroidectomy. Forty-two cases were followed up, 2 cases had postoperative hoarseness and unilateral recurrent laryngeal nerve paralysis, which were recovered 55 and 75 d after operation respectively. There was no bucking, voice blunt or permanent low calcium. One patient had abnormal sensation of neck skin after operation, and recovered gradually 3 months after operation.Conclusions:The stylized operation step in the SET can increase safety of surgery.
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Objective To analyze the clinical efficacy and safety of percutaneous microwave ablation guided by multimode ultrasound in the treatment of benign thyroid nodules.Methods The clinical data of 100 cases of benign thyroid nodules admitted from June 2017 to December 2018 were retrospectively analyzed.50 cases of benign thyroid nodules were treated by traditional open surgery as the control group,and 50 cases of benign thyroid nodules were treated by ultrasound-guided microwave ablation as the observation group.The complete clearance rate of lesion tissue and the incidence of comphcations were compared between the two groups.Results (1) The nodule clearance rate of the observation group was higher than that of the control group,with significant statistically difference (P ＜ 0.05).Compared with the control group (transient thyroid dysfunction 16％,recurrent laryngeal nerve injury 10％),the incidence of complications (transient hypothyroidism 2％,recurrent laryngeal nerve injury 0％) was significantly lower in the observation group (P ＜ 0.05).(2) The quality of life scores of the observation group and the control group were significantly higher than those before the treatment (P ＜ 0.05);The quality of life score of the observation group was significantly higher than that of the control group (P ＜ 0.05).Conclusions Compared with traditional open thyroidectomy,multimodal ultrasound-guided percutaneous microwave ablation has better efficacy and safety,which is worthy of wide application and promotion.
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ObjectiveTo discuss the more aesthetic and minimally invasive surgical approach of endoscopic thyroidectomy.Methods50 cases of endoscopic thyroidectomy via breast areola-axillary approach were retrospectively analyzed.Among these cases,12 received unilateral partial lobectomy,30 received unilateral total lobectomy and 8 received bilateral partial lobectomy.Results Endoscopic thyroidectomy was completed in all the patients.The intraoperative blood loss was ( 12.77 ± 20.12 ) ml.The operation time was (67.00 ± 21.28 )min.The postoperative hospital stay was (3.77 ± 0.50)days.Hoarseness occurred in 2 cases.All the 50 cases were followed up from 1 to 6 months and no other complication occurred.ConclusionEndoscopic thyroidectomy via breast areola-axillary approach is more aesthetic and minimally invasive; however,the operator needs an adaptive process for a better surgical view angle.