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首页> 外文期刊>Advances in Surgical Sciences >Volumetric Analysis is Useful for Predicting Use of Sternotomy During Retrosternal Thyroidectomy
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Volumetric Analysis is Useful for Predicting Use of Sternotomy During Retrosternal Thyroidectomy

机译：体积分析对于预测胸骨后胸骨切除术中的切开术的使用很有用

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Surgical removal is the recommended treatment for retrosternal goitre. This can be successfully achieved through a cervical incision in most cases, however occasionally a thoracic approach is required. Being able to predict the need for sternotomy would improve logistical efficiency, saving time and money, and allow patients to be better informed preoperatively. The aim of this study was to determine whether analysing thyroid volume on preoperative CT scans could help predict the use of sternotomy. To the best of our knowledge this is the first study investigating this. A retrospective study was conducted on 64 patients who underwent thyroidectomy for retrosternal goitre at the Golden Jubilee National Hospital, Scotland, between 2012-2016. Patient demographic information and pathological reports were obtained from databases. Preoperative CT scans were used for volumetric analysis. The total volume, the volume inferior to the level of the sternal notch (intrathoracic volume), and the anteroposterior diameter of the thoracic inlet were measured. An index of relative goitre size was calculated by dividing intrathoracic volume by thoracic inlet diameter. Mann-Whitney U tests and Fisher's exact tests were used to analyse continuous and categorical variables respectively. Goitres were successfully removed by a cervical incision alone in 55 patients, while thoracic intervention was needed in 9 cases (13.3%). Intrathoracic volume (p=0.0091) and volumetric index (p=0.0033) were significantly larger in those requiring sternotomy. Total volume was not significantly different. All other variables measured were similar in both groups. Our results suggest that assessing intrathoracic volume of goitre is useful in predicting the need for sternotomy. However, it is not able to completely rule out thoracic intervention. The volumetric index is likely to be a better predictor than volume alone.
机译：对于胸骨后甲状腺肿，建议手术切除。在大多数情况下，可以通过宫颈切口成功地做到这一点，但是有时需要采用胸腔入路。能够预测需要进行胸骨切开术将提高后勤效率，节省时间和金钱，并使术前更好地告知患者。这项研究的目的是确定在术前CT扫描中分析甲状腺容量是否可以帮助预测胸骨切开术的使用。据我们所知，这是第一个对此进行研究的研究。在2012年至2016年之间，对苏格兰金禧国家医院的64例行胸骨后甲状腺肿甲状腺切除术的患者进行了回顾性研究。从数据库中获得了患者的人口统计学信息和病理报告。术前CT扫描用于体积分析。测量总体积，低于胸骨切迹水平的体积（胸腔内体积）以及胸腔入口的前后直径。通过将胸腔内容积除以胸腔入口直径来计算相对甲状腺肿大小的指标。 Mann-Whitney U检验和Fisher精确检验分别用于分析连续变量和分类变量。仅通过宫颈切口成功切除了甲状腺肿55例，而需要胸腔介入的9例（13.3％）。在需要胸骨切开术的患者中，胸腔内容积（p = 0.0091）和容积指数（p = 0.0033）明显更大。总体积没有显着差异。两组中所有其他变量均相似。我们的结果表明，评估甲状腺肿的胸腔内容积有助于预测胸骨切开术的必要性。但是，它不能完全排除胸腔的介入。体积指数可能比单独的体积更好。

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