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经耳后达芬奇机器人甲状腺手术的初步经验

Retroauricular robotic thyroidectomy: a preliminary report of 5 cases

摘要目的:分析总结耳后入路达芬奇机器人甲状腺手术的经验,探讨此术式的可行性。方法:回顾性分析2018年5月—12月,在北京和睦家医院采用无注气耳后入路达芬奇机器人手术的甲状腺癌患者5例,其中男1例,女4例,年龄18~37岁。其中1例为甲状腺癌甲状腺全切除术后颈部淋巴结复发。分析总结临床特点、治疗及预后。结果:5例患者中行单侧甲状腺腺叶切除术1例,甲状腺全切除术3例,4例行颈侧清扫术,1例术中中转。5例病理均为甲状腺乳头状癌(papillary thyroid carcinoma,PTC),平均肿瘤大小1.3 cm,每侧平均手术时间约375 min。术后发生声带麻痹和低钙各1例次。结论:对部分经选择的甲状腺肿瘤患者,初步尝试经耳后机器人手术是可行的,是颈外入路甲状腺手术的选择之一。

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abstractsObjective:To explore the feasibility of retroauricular robotic thyroidectomy and introduce the experience and lessons.Methods:From May 2018 to December 2018, 5 consecutive cases underwent gasless retroauricular robotic thyroidectomy by using Davinci Si system at Beijing United Family Hospital, including 1 male and 4 females, aged from 18 to 37 years old. And they were retrospectively reviewed and analyzed. Among them, one case was a recurrence of cervical lympy nodes after total thyroidectomy for thyroid cancer.Results:Among 5 patients (mean age 32.4 years, mean tumor size 1.3 cm), one patient underwent unilateral thyroid lobectomies, 3 patients did total thyroidectomy and 4 patients did neck dissection. All patients had papillary thyroid carcinomas (PTC). The average time for unilateral retroauricular robotic thyroidectomy was 375 min. Intraoperative conversion to open surgery happened in one patient. Postoperative vocal cord paralysis and hypocalcemia developed in one of the patients.Conclusion:Retroauricular robotic thyroidectomy is feasible for selected patients and would be a potential alternative approach in remote-access approaches for thyroid surgery.

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