Endoscopic Thyroidectomy Via the Cervico-axillary Approach for Thyroid Cancer: Initial Experience in a Single Institute / 대한내분비외과학회지

PURPOSE: Endoscopic thyroidectomy using a cervico-axillary approach (CAA) provides optimal visualization with a smaller dissection plane. Despite the excellent cosmetic results and high patient satisfaction, the surgical and oncologic safety of CAA endoscopic surgery has not been fully established. The present study evaluated the feasibility, safety, and surgical outcomes of CAA endoscopic thyroidectomy. METHODS: From October 2009 to April 2012, 100 patients with papillary thyroid cancer underwent CAA endoscopic thyroidectomy. Patient demographics, pathologic features, and surgical outcomes including complications and recurrence were collected. RESULTS: CAA endoscopic thyroidectomy was successful in all patients, and none required conversion to open thyroidectomy. All patients underwent ipsilateral thyroid lobectomy with or without central compartment neck dissection. The mean tumor size was 1.0±0.6 cm (range, 0.5~1.6), and 35.0% of tumors showed extrathyroidal extension. The mean number of harvested lymph nodes was 4.1±4.4, and metastasis was found in 12.0% of patients. The mean surgical time was 175.2±50.4 min, mean intraoperative blood loss was 42.5±69.2 ml, and the mean hospital stay was 3.3±0.6 days. There were five cases of postoperative transient hypocalcemia and eight cases of vocal cord palsy. No permanent complication or postoperative bleeding was observed. Patients continued to be seen for a median period of 63.7 months, and no recurrence of thyroid cancer was seen. CONCLUSION: CAA endoscopic thyroidectomy is a feasible and safe procedure for low-risk thyroid cancer, with excellent cosmesis. It can be recommended as an alternative option for selected patients with low-risk thyroid cancer.

Insight, Self-esteem, and Coping Skills among Patients with Alcohol Addiction / 정신간호학회지

PURPOSE: This study was conducted to investigate the related factors of insight, self-esteem, and coping skills and the relationships among them in patients with alcohol addiction. METHODS: The participants enrolled in this study were 106 patients from two alcohol treatment hospitals in Gyeonggi Province. Data were collected from May, 12 to 20, 2010 using self-report questionnaires. The instruments were the Hanil Alcohol Insight Scale, Rosenberg Self-esteem Scale, and the Ways of Coping Checklist. Data were analyzed using the SPSS-Win 12.0 program. RESULTS: Among the participants, 24.5% had poor insight, 45.3% fair insight, and 30.2% good insight. Insights of participants who had experienced withdrawal symptoms (t=-3.79, p<.001) and of those not living with family (t=-2.07, p=.041) were higher than those who had not experienced the symptoms and who were not living with family. Self-esteem of participants living with family (F=3.60, p<.001) and of those with better academic backgrounds (F=3.39, p=.021) were higher than those of the other groups. Also, self-esteem showed a positive relation with active coping (r=.34, p<.001). CONCLUSION: The results of the present study suggest that mental health practitioners need to focus on insight and self-esteem enhancement, coping skill development when treating patients with alcohol addiction.