ABSTRACT
Surgical approaches for adenocarcinoma of esophagogastric junction have become controversial issues in recent years,including complete resection of tumors,negative proximal margin,complete lymph node dissection,safety of digestive tract reconstruction and reduction of perioperative complications.JCOG9502 trial in Japan is a well-known clinical trial on the surgical approach for adenocarcinoma of esophagogastric junction,which provides evidence-based medicine results for the transabdominal or transthoracic approach.However,due to the differences between the left and right thoracic approaches,the choice of a reasonable surgical approach has also become the focus of discussion between eastern and western scholars.With the development of minimally invasive surgery,it is possible to perform the operations combining laparoscopy and thoracoscopy in the future.
ABSTRACT
Objective To discuss the feasibility of totally transoral video-assisted thyroidectomy (TO-VAT).Methods Data of 30 hyperthyroidism patients treated with TOVAT from Jan.2014 to Dec.2016 were retrospectively analyzed.Index such as operative time,intraoperative blood loss,hospital stay,complication were recorded.Results No neck scar was found,and patients were satisfied with the cosmetic effects.The average surgical time was (97.3±13.4) min,blood loss 24.0(12.3～28.3)ml,hospital stay (2.0±0.5)d,cosmetic score 8.2± 0.3.No hoarse voice,drinking cough,bleeding,convulsion,or parathyroid injury happened.Two patients had swelling in the anterior cervicaarea,2 patients showed lower jaw numbness and 1 patient showed temporary hypoparathyroidism.During the follow up of 1 to 35 months,all were subjected to symptomatic management and recovered.Conclusion TOVAT is a safe and effective technique with the advantages of minor iniury,quicker recovery,fewer complications and good cosmetic effect.