Video-assisted neck surgery を用いた甲状腺切除術の経験

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Endoscopic surgery has been applied in various surgical fields because of its low invasiveness and lack of adverse cosmetic effects. Recently, applications of this technique to neck surgery have been reported with success.We performed an endoscopic operation on the thyroid in 3 patients with thyroid nodules by videoassisted neck surgery (VANS) using an anterior neck lift method. The region 10cm below the clavicle was selected for the initial approach to the thyroid,where neck cloths could be used. An additional lymph node dissection in the pre-and para-trachea was prophylactically performed in one patient, as the cytodiagnosis before surgery and the gross findings during operation regarding the thyroid nodule in this patient showed a possibility of follicular neoplasm. The size of the resected nodule was from 1.2 to 4.4cm (mean:3.0cm.), the operating time from 250 to 287min. (mean: 273min.), the amount of operative bleeding from 20 to 530ml. (mean:216.4ml.)and postoperative hospital stay from 6 to 8 days (mean:6.7 days).No complications after the surgery were recorded in any patients. It seems likely that the time and the amount of bleeding in VANS depend on the location or size of the nodule as well as the operative procedure.However,these problems could be solved with further experience.We believe that VANS will be of great use as an alternative to open neck surgery in patients with benign thyroid nodule, parathyroid adenoma, Graves disease or thyroid microcarcinoma with minimal invasion.
信州医学会の論文
2000-02-10

Video-assisted neck surgery を用いた甲状腺切除術の経験

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