west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "腔镜甲状腺手术" 5 results
  • Experiences of 420 Patients Underwent Total Endoscopic Thyroidectomy Via ChestBreast Approach

    ObjectiveTo discuss clinical significance of total endoscopic thyroidectomy (TET) via chest-breast approach. MethodsThe clinical data of 890 patients with thyroid diseases from September 2008 to September 2015 in this hospital were analyzed retrospectively. These patients were divided into TET group (received TET, n=420) and traditional group (received traditional thyroidectomy, n=470). The data of operation and postoperative recovery were compared between these two groups. ResultsThere was no significant difference between the TET group and the traditional group in the operation time [(73.571 4±28.533 9) min versus (70.212 8±27.199 8) min, t=1.80, P=0.072 7], bleeding volume [(30.714 3±14.225 1) mL versus (29.106 4±13.559 1) mL, t=1.73, P=0.084 8], postoperative drainage [(60.000 0±27.287 9) mL versus (56.595 7±27.803 5) mL, t=1.84, P=0.066 2], postoperative hospitalization time [(5.333 3±1.085 1) d versus (5.446 8± 1.089 0) d, t=1.55, P=0.120 4], postoperative 24 h pain score [(5.333 3±2.308 7) points versus (5.404 3±2.182 1) points, t=0.47, P=0.637 8] and postoperative injury rate of recurrent laryngeal nerve [0.714 2% (3/420) versus 0.851 1% (4/470), x2=0.053 2, P=0.817 6] and hypoparathyroidism rate [0.476 2% (2/420) versus 0.851 1% (4/470), x2=0.465 5, P=0.495 1]. The score of aesthetic effect of incision on day 7 after operation in the TET group was significantly higher than that in the traditional group [(7.809 5±1.296 9) points versus (3.361 7±1.391 8) points, t=49.14, P < 0.000 1]. ConclusionTET is safe and effective, and could improve cosmetic effect for patients with thyroid diseases.

    Release date: Export PDF Favorites Scan
  • 胸壁入路腔镜甲状腺手术中喉返神经的显露与保护

    目的探讨胸壁入路腔镜甲状腺手术中喉返神经显露的技巧,预防喉返神经医源性损伤。 方法回顾性收集2013年8月至2014年12月期间于兰州军区兰州总医院行胸壁入路腔镜甲状腺手术的45例患者的临床资料。手术时利用甲状腺下动脉、气管食管沟及甲状软骨下角显露喉返神经。 结果45例患者中,行单侧腺叶大部切除18例,行单侧腺叶切除22例,行双侧腺叶大部切除5例;手术时间108~125 min、(120±7)min,术中出血量18~25 mL、(23±4)mL。术后均无不适,无并发症发生。术后所有患者均获访,随访时间6~12个月,平均9个月。随访期间出现甲状腺功能减退2例,其余均正常,且2例甲状腺乳头状癌患者均未复发。 结论术中显露喉返神经有利于避免喉返神经损伤。

    Release date:2016-12-21 03:35 Export PDF Favorites Scan
  • 用累积和分析方法研究经口腔前庭入路腔镜甲状腺手术的学习曲线

    目的探讨经口腔前庭入路腔镜甲状腺手术的学习曲线,为学习该术式的医生提供参考。方法回顾性分析76例经口腔前庭入路腔镜甲状腺手术患者的临床资料,患者来源于2020年9月1日至2021年8月31日期间河南中医药大学第一附属医院普外科一病区,由有开放手术经验的同一主刀医师最初完成。采用累积和(cumulative sum,CUSUM)分析方法绘制学习曲线,研究具有开放手术经验的主刀医师从初步学习阶段过渡到熟练掌握阶段需要的最少学习病例数,比较不同学习曲线阶段患者的手术时间、术中出血量、术后引流量、术后住院时间、淋巴结清扫数目及术后并发症发生率指标。结果本研究中76例患者的中位手术时间为127.00 min。采用CUSUM分析方法绘制学习曲线,最佳拟合方程为CUSUMn=–0.394 4 n2+24.348 n+243.02(P<0.05,拟合系数=0.831)。CUSUM学习曲线在手术病例数第24例时达峰值,以此为界将学习曲线划分为学习提高期(n=24)和熟练掌握期(n=52)2个阶段,2个阶段患者的基线资料如年龄、性别、手术部位、肿瘤性质及肿瘤直径方面比较差异均无统计学意义(P>0.05),具有可比性。学习提高期的手术时间[中位数(上、下四分位数)]长于熟练掌握期 [163.50(136.25,194.50)min比120.00(110.00,135.00),Z=–5.144,P<0.001],且学习提高期术后并发症发生率高于熟练掌握期(50.0%比14.5%,χ2=6.474,P=0.011),2个阶段的术中出血量、术后引流量、术后住院时间及淋巴结清扫数目比较差异无统计学意义(P>0.05)。结论从本研究的结果提示,对于有腔镜经验的甲状腺专科医师,经口腔前庭入路腔镜甲状腺手术有明显的学习曲线,在完成24例手术后可认为从初步学习阶段过渡到熟练掌握阶段。

    Release date: Export PDF Favorites Scan
  • A prospective case-control study on the influence of Da Vinci Xi robot and endoscopic surgery on voice function in thyroid cancer

    ObjectiveTo compare the effect of robotic thyroidectomy and endoscopic thyroidectomy on the voice function. MethodsThe clinical data of 181 patients with differentiated thyroid cancer admitted to Panzhihua Central Hospital of Sichuan Province from March 2022 to June 2023 were analyzed retrospectively. According to the operative mode, this patients were divided into two groups: the endoscope group (n=91) and the robot group (n=90). The subjective and objective acoustic indicators were compared between the two groups at 1 day before operation and 1 week, 1 month and 3 months after operation. ResultsThere were no significant difference in voice handicap index (VHI)-10 scores between the two groups at different time points before and after operation (P>0.05). There were no significant difference of VHI-10 scores between preoperative and different postoperative phases in the robot group (P>0.05). The score of VHI-10 at different postoperative phases in the endoscopic group was higher than that at 1 d before operation (P<0.05). The incidence of voice dysfunction (VHI-10 score ≥8) was 1.1% (1/90), 1.1% (1/90) and 0.0% (0/90) in the robot group, 1.1% (1/91) , 2.2% (2/91) and 0.0% (0/91) in the endoscope group at 1 week, 1 month and 3 months after operation respectively, there were no significant difference between the two groups (P>0.05). The fundamental frequency of patients in the endoscopic group was lower than that at 1 d before operation (P<0.05), and there was no significant difference between each phase after operation and at 1 d before operation of fundamental frequency in the robot group (P>0.05). The fundamental frequency of patients in the endoscopic group was lower than that in the robot group at 1 week after operation (P<0.05). The maximum phonation time of each phase after operation in the robot group was not significantly different from that at 1 d before operation (P>0.05). The maximum phonation time of 1 week after operation in the endoscopic group was shorter than that at 1 d before operation (P<0.05) and also shorter than that in the robot group (P<0.05). There were no significant difference in fundamental frequency perturbation, amplitude perturbation, harmonic noise ratio and voice disorder severity index between the two groups at different phases before and after operation (P>0.05). ConclusionCompared with endoscopic thyroidectomy, the voice function of robotic thyroidectomy via bilateral axillary breast approach is better.

    Release date: Export PDF Favorites Scan
  • Research status and prospect of mandibular sensory dysfunction after transoral endoscopic thyroidectomy vestibular approach

    ObjectiveTo summarize the research status of mandibular sensory dysfunction after transoral endoscopic thyroidectomy vestibular approach (TOETVA), and explore its potential treatment methods and existing problems, and provide ideas and methods for future clinical treatments or research. MethodThe domestic and foreign literatures about peripheral nerve injury and its treatment after TOETVA were searched and reviewed. ResultsMental nerve injury was considered to be the main cause of mandibular sensory dysfunction after TOETVA. Due to the lack of unified definitions and assessment standards, the true incidence remained unclear. In order to reduce the risk of mental nerve injury, methods such as exposing the mental nerve and combining vestibular approaches during surgery had certain advantages. In terms of treatment, several methods promoting nerve repair were noteworthy, including B vitamins, nerve growth factors, physical therapy and so on. In addition, some auxiliary treatments of Traditional Chinese Medicine also showed effectiveness in promoting nerve regeneration. ConclusionsIt is essential to avoid damage to the mental nerve and mandibular tissues during surgery. For patients with significant complaints postoperatively, active treatment should be pursued. Establishing objective and quantifiable standards for evaluating mandibular sensory dysfunction and seeking effective clinical plans through a multidisciplinary approach may be the direction for future research.

    Release date: Export PDF Favorites Scan
1 pages Previous 1 Next

Format

Content