Endoscopic Thyroidectomy for Large-Sized Goiters: Merits of the Axillo-Breast Approach with Gas Insufflation.

IF 1.7 Q4 ENDOCRINOLOGY & METABOLISM Journal of Thyroid Research Pub Date : 2024-02-06 eCollection Date: 2024-01-01 DOI:10.1155/2024/9487076
Islam A Elzahaby, Essam Attia Ali, Ahmed Mohammed Farid, Mohamed Abd El Ghaffar Saleh, Ahmed Abdallah
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Abstract

Background: Several minimal access approaches to the thyroid gland have been widely applied; nevertheless, such approaches are still challenging when dealing with large-sized thyroid nodules or goiters. We hereby evaluated the outcomes and highlighted the merits of endoscopic axillo-breast hemithyroidectomy (EABH) for large-sized unilateral goiters.

Methods: Patients underwent EABH for unilateral large thyroid nodules ≥6 cm in its greatest dimension or unilateral large goiter (≥60 ml sonographic volume) whatever the size of its contained nodules were identified from a prospectively maintained database. Their demographic data, clinicopathological profiles, and surgical and esthetic outcomes are reported and analyzed.

Results: Over a 2-year period, 33 patients matched the selection criteria. Their mean age was 34.75 ± 11.39 years. There were 30 women and 3 men. The majority of nodules were radiologically TIRADS3 and cytologically Bethesda 3. The mean sonographic dominant nodule greatest dimension was 5.29 ± 1.48 cm (range: 3-9.5 cm). The mean sonographic volume of the pathological lobe was 101.86 ± 54.45 ml (range: 60.11-236.88 ml). All cases were completed endoscopically with no conversion to open. The mean operative time was 110.76 ± 18.75 minutes. No significant postoperative complications were reported except for one case with temporary vocal cord paresis. Most (87.9%) of the patients were extremely satisfied with the procedure.

Conclusion: EABH with our suggested key steps could be considered an effective valid approach for unilateral large goiters in trained hands and in patients desirous for cosmesis.

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内窥镜甲状腺切除术治疗大型甲状腺肿:腋窝-乳房入路与气体灌注的优点。
背景:甲状腺微创手术已被广泛应用,但在处理大尺寸甲状腺结节或甲状腺肿时,此类手术仍具有挑战性。我们在此评估了内镜腋窝-乳房半甲状腺切除术(EABH)治疗单侧大甲状腺肿的效果,并强调了其优点:方法:从前瞻性数据库中筛选出因单侧甲状腺大结节(最大尺寸≥6厘米)或单侧大甲状腺肿(声像图体积≥60毫升)(无论其所含结节的大小)而接受内镜腋窝-乳房半甲状腺切除术的患者。报告并分析了他们的人口统计学数据、临床病理学特征以及手术和美容效果:在两年的时间里,有 33 名患者符合选择标准。他们的平均年龄为(34.75 ± 11.39)岁。其中女性 30 人,男性 3 人。大多数结节的放射学检查结果为 TIRADS3,细胞学检查结果为 Bethesda 3。声像图显性结节的平均最大尺寸为 5.29 ± 1.48 厘米(范围:3-9.5 厘米)。病理叶的平均声像图体积为 101.86 ± 54.45 毫升(范围:60.11-236.88 毫升)。所有病例均在内镜下完成,无一例转为开腹手术。平均手术时间为 110.76 ± 18.75 分钟。除一例出现暂时性声带麻痹外,无明显术后并发症。大多数患者(87.9%)对手术非常满意:结论:采用我们建议的关键步骤进行EABH手术,对于训练有素的医生和追求美观的患者来说,是治疗单侧大甲状腺肿的有效方法。
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来源期刊
Journal of Thyroid Research
Journal of Thyroid Research ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
10
审稿时长
17 weeks
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