Résumé
OBJECTIVE@#To explore the safety and feasibility of endoscopic thyroidectomies through modified chest and mammary areola approach.@*METHOD@#We retrospectively analyzed 122 cases of endoscopic thyroidectomies through a modified chest and mammary areola approach without extensive dissection of thoracic flap. The information about general status, surgical procedures and techniques, complications, etc. were summarized and discussed.@*RESULT@#One hundred and twenty-one cases were operated successfully while 1 case was converted to video-assisted thyroidectomy through infraclavicular approach. The maximum diameter of the mass was (2.05 ± 1.06) cm, mean operation time was (88.61 ± 27.87) min, the operative blood loss was (31.23 ± 16.14) ml, duration of postoperative drainage was (3.54 ± 0.88) d and overall drainage volume was (139.09 ± 95.93) ml. Parathyroid glands were detected in specimens of 9 cases while no case of permanent postoperative hypocalcaemia was displayed. 6 cases of hoarseness were developed. One case experienced conversion surgery, all the others obtained satisfactory cosmetic result. All cases were followed up for 0-24 months without relapse and metastasis of the disease.@*CONCLUSION@#Endoscopic thyroidectomy via a modified chest and breast areola approach can facilitated the procedure and avoid extensive dissection of thoracic flap, and proved to be safe and effective.
Sujets)
Humains , Perte sanguine peropératoire , Région mammaire , Chirurgie générale , Drainage , Endoscopie , Études de faisabilité , Complications postopératoires , Études rétrospectives , Lambeaux chirurgicaux , Thyroïdectomie , MéthodesRésumé
OBJECTIVE@#To explore the safety, effectiveness and feasibility of 3D laparoscopy in thyroidectomy via modified chest and mammary areola approach comparing with 2D.@*METHOD@#Twenty six cases received 3D laparoscopic thyroidectomy (3D group) and 34 cases experienced 2D (2D group). We compared the indexes about general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc between two groups.@*RESULT@#Eight cases of thyroid cancer were detected in 3D group and 3 cases in 2D group. While there was no statistical difference between two groups with respect to other observation indexes such as other general status, operation time, operative blood loss, duration and overall volume of postoperative drainage, complications, etc.@*CONCLUSION@#3D laparoscopic thyroidectomy via modified chest and mammary areola approach is a safe, effective and feasible procedure, and it may substitute the place of 2D in the future.
Sujets)
Humains , Perte sanguine peropératoire , Région mammaire , Chirurgie générale , Drainage , Laparoscopie , Méthodes , Période postopératoire , Tumeurs de la thyroïde , Chirurgie générale , Thyroïdectomie , Méthodes , Résultat thérapeutiqueRésumé
Objective To approach the prognostic factors of head and neck adenoid cystic carcinoma.Methods Fifty-eight head and neck adenoid cystic carcinomas were treated from January 1999 to December 2007.The demographic and clinicopathological data were obtained from a retrospective chart review.The follow-up and survival analysis were carried out to analyze the significant prognostic factors.Results Using the univariate analysis,the variables,such as histologic type,perineural invasion,vascular invasion,recurrence,metastasis and TNM stage were found significantly associated with a worse prognosis (P ＜ 0.05 ).Multivariate analysis showed that histologic type,perineural invasion and TNM stage had an independent prognostic effect on survival (P ＜ 0.05 ).Conclusion The variables including histologic type,TNM stage,perineural and vascular invasion,recurrence and metastasis are important prognostic factors for head and neck adenoid cystic carcinoma.