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首页> 外文期刊>Surgical Endoscopy >Endoscopic lateral neck dissection via breast approach for papillary thyroid carcinoma: a preliminary report.
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Endoscopic lateral neck dissection via breast approach for papillary thyroid carcinoma: a preliminary report.

机译：内镜下通过乳房入路行颈内镜清扫术治疗甲状腺乳头状甲状腺癌：初步报告。

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BACKGROUND: Traditional open surgery for lateral neck dissection for patients with papillary thyroid carcinoma (PTC) requires a large incision to obtain adequate exposure of the surgical field, leaving an unsightly scar. We applied scarless (in the neck) endoscopic thyroidectomy (SET) via breast approach to lateral neck dissection for PTC and evaluated its feasibility and safety. METHODS: Between July 2007 and October 2009, 11 T1 (tumor size not exceeding 2 cm) low-risk PTC female patients with suspected lymph node metastasis at level III or IV were selected for this procedure. After accomplishing thyroidectomy and central compartment dissection, ipsilateral level III and IV dissection via breast approach was performed. The steps of endoscopic lateral neck dissection were similar to that of conventional surgery except that the lateral cervical compartment was exposed by splitting the sternocleidomastoid muscles (SCM) longitudinally. RESULTS: This procedure was carried out successfully in all 11 patients. Mean operative time for lateral neck dissection was 94.3 min (range 77-123 min). No significant blood loss or complications occurred. Average postoperative hospital stay was 4.3 days (range 3-6 days). Ten patients had lymph node metastasis in both central and lateral zones, while one patient had central zone metastasis only. Mean lymph node yield in the lateral compartment was 18.3 (range 9-26). No evidence of residual or recurrent disease was found at follow-up. The cosmetic results of this procedure were excellent. CONCLUSIONS: Endoscopic lateral neck dissection via breast approach is feasible and safe with excellent cosmetic results for selected cases of PTC. Further study based on large comparative series and long-term follow-up is needed to verify its oncological validity.
机译：背景：传统的甲状腺乳头状癌（PTC）患者的侧颈清扫术需要大切口以充分暴露手术区域，并留下难看的疤痕。我们通过乳房入路无刺（颈部）内窥镜甲状腺切除术（SET）对PTC进行侧颈解剖，并评估了其可行性和安全性。方法：从2007年7月至2009年10月，选择11例T1（肿瘤大小不超过2厘米）的低危PTC女性患者，怀疑其在III或IV级淋巴结转移。完成甲状腺切除术和中央隔室解剖后，通过乳房入路进行同侧III和IV级解剖。内窥镜侧颈清扫的步骤与常规手术相似，不同之处在于通过纵向分裂胸锁乳突肌（SCM）暴露了颈侧室。结果：该手术在所有11例患者中均成功进行。颈部外侧清扫术的平均手术时间为94.3分钟（77-123分钟）。没有发生明显的失血或并发症。术后平均住院天数为4.3天（范围3-6天）。 10名患者在中央和外侧区域均发生淋巴结转移，而1名患者仅发生了中央区域转移。外侧区室的平均淋巴结产率为18.3（范围9-26）。随访中未发现残留或复发性疾病的证据。该过程的美容效果极好。结论：对于部分PTC病例，通过乳房入路的内镜下颈侧颈淋巴结清扫术是可行且安全的，具有出色的美容效果。需要进一步的研究以较大的比较系列和长期随访为基础，以验证其肿瘤学有效性。

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