吸引器支撑式免充气经口腔镜甲状腺癌手术的安全性及可行性研究_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

曾沁欣 ¹ , 吴剑 ² , 刘虹 ² , 吴国洋 ³ ,  王浩斌 ⁴

1. ;
2. ;
3. ;
4. ;

Corresponding author：

王浩斌, Email: wanghaobin@swjtu.edu.cn

Keywords：

甲状腺乳头状癌; 多功能吸引器; 免充气; 经口入路; 甲状腺切除术

DOI：

10.7507/1007-9424.202503033

Video：

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目的探讨吸引器支撑式免充气经口腔镜甲状腺癌手术的安全性及可行性。方法回顾性分析2022年7月至2024年1月期间在成都市第三人民医院乳腺甲状腺外科接受吸引器支撑式免充气经口腔镜甲状腺癌手术的72例甲状腺乳头状癌患者的临床资料。结果 72例患者均在腔镜下顺利完成手术，无中转开放手术。手术时间（102±27）min，术后住院时间（3.4±1.1）d。术后并发症包括1例暂时性喉返神经麻痹，2例短暂性甲状旁腺功能减退，18例短暂性下唇麻木，2例暂时性下颌部感觉障碍，2例暂时性嗅觉、味觉丧失，以上并发症患者均在1～3个月内恢复，未见该术式的特异性并发症。所有患者均获得随访，中位随访时间21个月（12～26个月），随访过程中无肿瘤局部残留或复发。结论吸引器支撑式免充气经口腔镜甲状腺癌手术治疗甲状腺乳头状癌安全可行。

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2.	Zhang D, Park D, Sun H, et al. Indications, benefits and risks of transoral thyroidectomy. Best Pract Res Clin Endocrinol Metab, 2019, 33(4): 101280. doi: 10.1016/j.beem.2019.05.004.
3.	Tae K, Ji YB, Song CM, et al. Robotic and endoscopic thyroid surgery: evolution and advances. Clin Exp Otorhinolaryngol, 2019, 12(1): 1-11.
4.	Tae K. Complications of transoral thyroidectomy: overview and update. Clin Exp Otorhinolaryngol, 2021, 14(2): 169-178.
5.	王平, 吴国洋, 田文, 等. 经口腔前庭入路腔镜甲状腺手术专家共识 (2018版). 中国实用外科杂志, 2018, 38(10): 1104-1107.
6.	Wilhelm T, Metzig A. Video. Endoscopic minimally invasive thyroidectomy: first clinical experience. Surg Endosc, 2010, 24(7): 1757-1758.
7.	傅锦波, 陈清贵, 罗晔哲, 等. 经口入路腔镜下甲状腺切除手术五例经验. 中华普通外科杂志, 2012, 27(4): 279-281.
8.	王存川, 翟贺宁, 刘卫军, 等. 经口腔前庭腔镜甲状腺切除术6例经验. 中国内镜杂志, 2013, 19(4): 363-366.
9.	Bonjer HJ, Hazebroek EJ, Kazemier G, et al. Open versus closed establishment of pneumoperitoneum in laparoscopic surgery. Br J Surg, 1997, 84(5): 599-602.
10.	Park EY, Kwon JY, Kim KJ. Carbon dioxide embolism during laparoscopic surgery. Yonsei Med J, 2012, 53(3): 459-466.
11.	Nakajo A, Arima H, Hirata M, et al. Trans-oral video-assisted neck surgery (TOVANS). A new transoral technique of endoscopic thyroidectomy with gasless premandible approach. Surg Endosc, 2013, 27(4): 1105-1110.
12.	Park JO, Park YJ, Kim MR, et al. Gasless transoral endoscopic thyroidectomy vestibular approach (gasless TOETVA). Surg Endosc, 2019, 33(9): 3034-3039.
13.	Sheng X, Liu J, Fang J, et al. En bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach in papillary thyroid carcinoma. Front Endocrinol (Lausanne), 2023, 14: 1130791. doi: 10.3389/fendo.2023.1130791.
14.	赵敏健, 刘黎明, 余召师, 等. 撑开式拉钩在经口免充气单孔腔镜甲状腺手术中的应用. 中华普通外科杂志, 2020, 35(3): 257-258.
15.	Udelsman R, Anuwong A, Oprea AD, et al. Trans-oral vestibular endocrine surgery: a new technique in the United States. Ann Surg, 2016, 264(6): e13-e16. doi: 10.1097/SLA.0000000000002001.
16.	Tae K. Complications of transoral thyroidectomy: overview and update. Clin Exp Otorhinolaryngol, 2021, 14(2): 169-178.
17.	孙一鸣, 吴峰, 王松, 等. 经口腔前庭入路腔镜甲状腺术后下颌感觉功能障碍研究现状及展望. 中国普外基础与临床杂志, 2024, 31(8): 1012-1018.
18.	Farzana N, Tewari P, Sureka S, et al. Parosmia and dysgeusia after intravenous propofol-based general anesthesia: a case report. Ann Card Anaesth, 2022, 25(1): 112-115.
19.	Wang C, Pan Y, Guan J, et al. Anosmia and ageusia after intravenous esketamine and propofol-based general anesthesia. Asian J Surg, 2023, 46(11): 5219-5221.
20.	Du W, Xu Z, Wang W, et al. A case of anosmia and hypogeusia as a complication of propofol. J Anesth, 2018, 32(2): 293-296.

1. Luna-Ortiz K, Gómez-Pedraza A, Anuwong A. Lessons learned from the transoral endoscopic thyroidectomy with vestibular approach (TOETVA) for the treatment of thyroid carcinoma. Ann Surg Oncol, 2020, 27(5): 1356-1360.
2. Zhang D, Park D, Sun H, et al. Indications, benefits and risks of transoral thyroidectomy. Best Pract Res Clin Endocrinol Metab, 2019, 33(4): 101280. doi: 10.1016/j.beem.2019.05.004.
3. Tae K, Ji YB, Song CM, et al. Robotic and endoscopic thyroid surgery: evolution and advances. Clin Exp Otorhinolaryngol, 2019, 12(1): 1-11.
4. Tae K. Complications of transoral thyroidectomy: overview and update. Clin Exp Otorhinolaryngol, 2021, 14(2): 169-178.
5. 王平, 吴国洋, 田文, 等. 经口腔前庭入路腔镜甲状腺手术专家共识 (2018版). 中国实用外科杂志, 2018, 38(10): 1104-1107.
6. Wilhelm T, Metzig A. Video. Endoscopic minimally invasive thyroidectomy: first clinical experience. Surg Endosc, 2010, 24(7): 1757-1758.
7. 傅锦波, 陈清贵, 罗晔哲, 等. 经口入路腔镜下甲状腺切除手术五例经验. 中华普通外科杂志, 2012, 27(4): 279-281.
8. 王存川, 翟贺宁, 刘卫军, 等. 经口腔前庭腔镜甲状腺切除术6例经验. 中国内镜杂志, 2013, 19(4): 363-366.
9. Bonjer HJ, Hazebroek EJ, Kazemier G, et al. Open versus closed establishment of pneumoperitoneum in laparoscopic surgery. Br J Surg, 1997, 84(5): 599-602.
10. Park EY, Kwon JY, Kim KJ. Carbon dioxide embolism during laparoscopic surgery. Yonsei Med J, 2012, 53(3): 459-466.
11. Nakajo A, Arima H, Hirata M, et al. Trans-oral video-assisted neck surgery (TOVANS). A new transoral technique of endoscopic thyroidectomy with gasless premandible approach. Surg Endosc, 2013, 27(4): 1105-1110.
12. Park JO, Park YJ, Kim MR, et al. Gasless transoral endoscopic thyroidectomy vestibular approach (gasless TOETVA). Surg Endosc, 2019, 33(9): 3034-3039.
13. Sheng X, Liu J, Fang J, et al. En bloc resection of total thyroid and bilateral central compartment lymph nodes via a gasless transoral approach in papillary thyroid carcinoma. Front Endocrinol (Lausanne), 2023, 14: 1130791. doi: 10.3389/fendo.2023.1130791.
14. 赵敏健, 刘黎明, 余召师, 等. 撑开式拉钩在经口免充气单孔腔镜甲状腺手术中的应用. 中华普通外科杂志, 2020, 35(3): 257-258.
15. Udelsman R, Anuwong A, Oprea AD, et al. Trans-oral vestibular endocrine surgery: a new technique in the United States. Ann Surg, 2016, 264(6): e13-e16. doi: 10.1097/SLA.0000000000002001.
16. Tae K. Complications of transoral thyroidectomy: overview and update. Clin Exp Otorhinolaryngol, 2021, 14(2): 169-178.
17. 孙一鸣, 吴峰, 王松, 等. 经口腔前庭入路腔镜甲状腺术后下颌感觉功能障碍研究现状及展望. 中国普外基础与临床杂志, 2024, 31(8): 1012-1018.
18. Farzana N, Tewari P, Sureka S, et al. Parosmia and dysgeusia after intravenous propofol-based general anesthesia: a case report. Ann Card Anaesth, 2022, 25(1): 112-115.
19. Wang C, Pan Y, Guan J, et al. Anosmia and ageusia after intravenous esketamine and propofol-based general anesthesia. Asian J Surg, 2023, 46(11): 5219-5221.
20. Du W, Xu Z, Wang W, et al. A case of anosmia and hypogeusia as a complication of propofol. J Anesth, 2018, 32(2): 293-296.

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