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Tiroidektomi Endoskopi Transoral dengan Pendekatan Vestibular Untuk Nodul Tiroid: Serial 12 Pasien Pertama di RSUP Prof. Dr. R. D. Kandou 采用前庭入路的经口内窥镜甲状腺切除术治疗甲状腺结节:R. D. Kandou 教授医院首批 12 例患者系列报道
Pub Date : 2024-02-01 DOI: 10.35790/msj.v6i2.51515
Riston R. Sitompul, Victor Pontoh, Marselus A. Merung, Christian Manginstar
Abstract: Transoral endoscopic thyroidectomy by vestibular approach (TOETVA), showed a comparable result to the conventional thyroidectomy, without any scar as the advantage. This study aimed to present the feasibility and safety of patients with solitary or multinodular goitre and or papillary thyroid carcinoma using TOETVA. This was a case series using 12 patients recorded undergoing TOETVA procedure. Eleven patients’ specimen obtained through FNAB resulted as benign nodule. In one patient, the nodule was malignant and unilateral, therefore, endoscopic isthmolobectomy was performed. Outcomes and measures included conversion to open conventional surgery, operative time, intraoperative blood loss, size of the thyroid gland, postoperative hospital stay, visual analogue scores, and postoperative complications. The results showed a total of 12 patients; all were women, aged 33-64 years. The size of thyroid nodules ranged from 2 cm to 7 cm. One patient got converted to open isthmus lobectomy. In this series, none of the patients were noted to have mental nerve injury but two patients developed anterior neck chin skin bruise. The mean postoperative VAS measurements were 2, 1, and no pain or 0, on the first, second, third, and seventh postoperative days, respectively. In conclusion, endoscopic thyroidectomy is feasible, safe, and comparable to open thyroidectomy and yields excellent aesthetic results.Keywords: endoscopic thyroidectomy; minimally invasive surgical procedures; thyroid neoplasms  Abstrak: Tiroidektomi endoskopi transoral dengan pendekatan vestibular (TOETVA), menunjuk-kan hasil sebanding dengan tiroidektomi konvensional, tanpa adanya bekas luka sebagai keuntungan. Penelitian ini bertujuan untuk menyajikan kelayakan dan keamanan pasien dengan penyakit gondok soliter atau multinodular dan atau karsinoma tiroid papiler menggunakan TOETVA. Jenis penelitian ialah serial kasus yang menjalani TOETVA selama Januari 2018 hingga Desember 2019 di RSUP Prof. Dr. R. D. Kandou. Terdapat 12 pasien tercatat menjalani prosedur TOETVA; 11 spesimen pasien diambil melalui FNAB dan menghasilkan nodul jinak. Pada salah satu pasien didapatkan nodul ganas unilateral sehingga dilakukan istmolobektomi endoskopi. Hasil dan tindakan termasuk konversi ke operasi konvensional terbuka, waktu operasi, kehilangan darah intraoperatif, ukuran kelenjar tiroid, rawat inap pasca operasi, VAS, dan komplikasi pasca operasi. Hasil penelitian mendapatkan 12 pasien, semuanya berjenis kelamin perempuan, berusia 33-64 tahun. Ukuran nodul tiroid berkisar 2 - 7 cm. Satu pasien diubah menjadi lobektomi terbuka. Tidak ada pasien yang tercatat mengalami cedera saraf mental, namun dua pasien mengalami memar pada kulit dagu leher bagian depan. Rerata pengukuran VAS pasca operasi ialah 2, 1, dan tidak nyeri atau 0, masing-masing pada hari pertama, kedua, ketiga, dan ketujuh pasca operasi. Simpulan penelitian ini ialah tiroidektomi endoskopi layak dilakukan, aman dan sebanding dengan tiro
摘要:经口内镜前庭入路甲状腺切除术(TOETVA)的效果与传统甲状腺切除术相当,且无疤痕。本研究旨在介绍单发或多发结节性甲状腺肿和甲状腺乳头状癌患者使用TOETVA的可行性和安全性。这是一项病例系列研究,共记录了12名接受TOETVA手术的患者。11名患者通过FNAB获得的标本为良性结节。一名患者的结节为恶性且为单侧,因此进行了内镜下峡部切除术。结果和测量指标包括转为开放式传统手术、手术时间、术中失血量、甲状腺大小、术后住院时间、视觉模拟评分和术后并发症。结果显示,共有12名患者接受了手术,均为女性,年龄在33-64岁之间。甲状腺结节的大小从2厘米到7厘米不等。一名患者转为开放性峡部甲状腺叶切除术。在这一系列患者中,没有人发现精神神经损伤,但有两名患者出现了颈前下巴皮肤瘀伤。术后第一天、第二天、第三天和第七天的平均 VAS 测量值分别为 2、1、无痛或 0。关键词:内镜甲状腺切除术;微创外科手术;甲状腺肿瘤 Abstrak:经口腔内镜甲状腺切除术(TOETVA),是一种通过口腔内镜进行的甲状腺肿瘤切除术。该疗法用于治疗单发或多发甲状腺结节和甲状腺乳头状瘤(TOETVA)。该项目于2018年1月至2019年9月期间在RSUP教授R.D.Kandou博士的指导下开展。共有12名学生参加了TOETVA项目;11名学生参加了FNAB项目,并获得了Jinak奖。其中大部分患者的结节是单侧的,而内窥镜下的结节则是双侧的。这些患者的病史和临床表现包括手术时间、手术时间、术中出血量、甲状腺肿大、术后出血量、VAS 和术后并发症。共有 12 名患者接受了手术,他们的年龄都在 33-64 岁之间。甲状腺结节直径为 2 - 7 厘米。大部分癌症患者都有甲状腺结节。有的患者会出现精神障碍,而有的患者则会出现精神障碍。手术后 VAS 值分别为 2、1 和 0,在手术前、手术中、手术后和手术后都会发生变化。其特征是经口甲状腺瘤;微创;甲状腺肿瘤。
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